Assessment of cardiovascular risk in a slum population in Kenya: use of World Health Organisation/International Society of Hypertension (WHO/ISH) risk prediction charts - secondary analyses of a household survey
Assessment of cardiovascular risk in a slum population in Kenya: use of World Health Organisation/International Society of Hypertension (WHO/ISH) risk prediction charts - secondary analyses of a household survey
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肯尼亚贫民窟人口的心血管风险评估：使用世界卫生组织/国际高血压协会 (WHO/ISH) 风险预测图表 - 家庭调查的二次分析
作者：
A. Vusirikala;F. Wekesah;C. Kyobutungi;O. Oyebode
虽然心血管疾病（CVD）在低收入和中等收入国家（LMICs）日益重要，但关于心血管疾病是城市穷人（包括贫民窟居民）的一个主要公共卫生问题，存在相互矛盾的观点。我们研究了贫民窟人口的多变量风险预测，并评估了应用该工具后10年内心血管相关死亡的数量。我们使用2008年5月至2009年4月期间内罗毕城市健康和人口监测系统（NUHDSS）人口（两个贫民窟社区的居民）的数据。这是来自横断面调查的二次数据分析。我们使用世界卫生组织/国际高血压学会（WHO/ISH）心血管风险预测工具检查贫民窟人口10年主要心血管疾病事件的风险。还介绍了截至2018年6月报告的队列中心血管疾病死亡人数，并通过尸检确定。3063名年龄在40岁以上的男性和女性符合WHO/ISH风险预测工具所需变量的完整数据。大多数研究成员（2895,94.5%）预计在未来10年内心血管事件的“低”风险（<10%），只有51人（1.7%）具有“高”心血管事件风险（≥20%）。截至2018年6月，该队列报告了91例心血管疾病死亡。在低风险人群中，74人（2.6%）死于心血管疾病。9人（7.7%）被分类为10%至20%的风险，8人（15.9%）被分类为bb0至20%的风险，被确定为死于心血管疾病。本研究表明，与在其他低收入和中等收入国家人群中应用多变量风险预测工具的结果相比，肯尼亚内罗毕贫民窟人口的心血管疾病风险较低。这对这些情况下的卫生服务规划具有影响。
Objectives Although cardiovascular disease (CVD) is of growing importance in low- and middle-income countries (LMICs), there are conflicting views regarding CVD as a major public health problem for the urban poor, including those living in slums. We examine multivariable risk prediction in a slum population and assess the number of cardiovascular related deaths within 10 years of application of the tool. Setting We use data from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) population (residents of two slum communities) between May 2008 and April 2009. Design This is a secondary data analysis from a cross-sectional survey. We use the WHO/International Society of Hypertension (WHO/ISH) cardiovascular risk prediction tool to examine 10-year risk of major CVD events in a slum population. CVD deaths in the cohort, reported up until June 2018 and identified through verbal autopsy are also presented. Participants 3063 men and women aged over 40 years with complete data for variables needed for the WHO/ISH risk prediction tool were eligible to take part. Results The majority of study members (2895, 94.5%) were predicted to have ‘low’ risk (<10%) of a cardiovascular event over the next 10 years and just 51 (1.7%) to have ‘high’ CVD risk (≥20%). 91 CVD deaths were reported for the cohort up until June 2018. Of individuals classified as low risk, 74 (2.6%) were identified as having died of CVD. Nine (7.7%) individuals classified at 10% to 20% risk and eight (15.9%) classified at >20% were identified as dying of CVD. Conclusions This study shows that there is a low risk profile of CVD in this slum population in Nairobi, Kenya, in comparison to results from application of multivariable risk prediction tools in other LMIC populations. This has implications for health service planning in these contexts.
DOI：
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发表时间：
2011
期刊：
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影响因子：
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作者：
A. Alwan
通讯作者：
A. Alwan