PLoS ONE (Jan 2021)

Validation of the World Health Organization/ International Society of Hypertension (WHO/ISH) cardiovascular risk predictions in Sri Lankans based on findings from a prospective cohort study.

  • U B Thulani,
  • K C D Mettananda,
  • D T D Warnakulasuriya,
  • T S G Peiris,
  • K T A A Kasturiratne,
  • U K Ranawaka,
  • S Chakrewarthy,
  • A S Dassanayake,
  • S A F Kurukulasooriya,
  • M A Niriella,
  • S T de Silva,
  • A P Pathmeswaran,
  • N Kato,
  • H J de Silva,
  • A R Wickremasinghe

DOI
https://doi.org/10.1371/journal.pone.0252267
Journal volume & issue
Vol. 16, no. 6
p. e0252267

Abstract

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Introduction and objectivesThere are no cardiovascular (CV) risk prediction models for Sri Lankans. Different risk prediction models not validated for Sri Lankans are being used to predict CV risk of Sri Lankans. We validated the WHO/ISH (SEAR-B) risk prediction charts prospectively in a population-based cohort of Sri Lankans.MethodWe selected 40-64 year-old participants from the Ragama Medical Officer of Health (MOH) area in 2007 by stratified random sampling and followed them up for 10 years. Ten-year risk predictions of a fatal/non-fatal cardiovascular event (CVE) in 2007 were calculated using WHO/ISH (SEAR-B) charts with and without cholesterol. The CVEs that occurred from 2007-2017 were ascertained. Risk predictions in 2007 were validated against observed CVEs in 2017.ResultsOf 2517 participants, the mean age was 53.7 year (SD: 6.7) and 1132 (45%) were males. Using WHO/ISH chart with cholesterol, the percentages of subjects with a 10-year CV risk ConclusionsWHO/ISH (SEAR B) risk prediction charts with-and without-cholesterol may be used in Sri Lanka. Risk charts are more predictive in males than in females and for lower-risk categories. The predictions when stratifying into 2 categories, low risk (<20%) and high risk (≥20%), are more appropriate in clinical practice.