4.6 Article

Ten-years cardiovascular risk among Bangladeshi population using non-laboratory-based risk chart of the World Health Organization: Findings from a nationally representative survey

Journal

PLOS ONE
Volume 16, Issue 5, Pages -

Publisher

PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0251967

Keywords

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Funding

  1. National Nutrition Services (NNS), Institute of Public Health Nutrition, Ministry of Health and Family Welfare, Government of Bangladesh
  2. National Institute for Health Research (NIHR) from the UK Government [16/136/68]
  3. Wellcome Trust [212945/Z/18/Z]
  4. Wellcome Trust [212945/Z/18/Z] Funding Source: Wellcome Trust

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The study utilized a non-laboratory based cardiovascular disease risk chart developed by the World Health Organization to estimate the CVD risk among the Bangladeshi population aged 40-74, finding that one in four Bangladeshi adults had elevated levels of CVD risk, with males at higher risk of CVD events. Factors such as being unmarried, lack of physical activity, and smoking were associated with elevated CVD risk.
The World Health Organization (WHO) has recently developed a non-laboratory based cardiovascular disease (CVD) risk chart considering the parameters age, sex, current smoking status, systolic blood pressure, and body mass index. Using the chart, we estimated the 10-years CVD risk among the Bangladeshi population aged 40-74 years. We analyzed data from a nationally representative survey conducted in 2018-19. The survey enrolled participants from 82 clusters (57 rural, 15 non-slum urban, and 10 slums) selected by multistage cluster sampling. Using the non-laboratory-based CVD risk chart of the World Health Organization (WHO), we categorized the participants into 5 risk groups: very low (<5%), low (5% to <10%), moderate (10% to <20%), high (20% to <30%) and very high (> = 30%) risk. We performed descriptive analyses to report the distribution of CVD risk and carried out univariable and multivariable logistic regression to identify factors associated with elevated CVD risk (> = 10% CVD risk). Of the 7,381 participants, 46.0% were female. The median age (IQR) was 59.0 (48.0-64.7) years. Overall, the prevalence of very low, low, moderate, high, and very high CVD risk was 34.7%, 37.8%, 25.9%, 1.6%, and 0.1%, respectively. Elevated CVD risk (> = 10%) was associated with poor education, currently unmarried, insufficient physical inactivity, smokeless tobacco use, and self-reported diabetes in both sexes, higher household income, and higher sedentary time among males, and slum-dwelling and non-Muslim religions among females. One in every four Bangladeshi adults had elevated levels of CVD risk, and males are at higher risk of occurring CVD events. Non-laboratory-based risk prediction charts can be effectively used in low resource settings. The government of Bangladesh and other developing countries should train the primary health care workers on the use of WHO non-laboratory-based CVD risk charts, especially in settings where laboratory tests are not available.

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