Cardiovascular risk assessment tools in Asia

Yuqing Zhang, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
Huanhuan Miao, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
Yook Chin Chia, Sunway University
Peera Buranakitjaroen, Siriraj Hospital
Saulat Siddique, Punjab Medical Center
Jinho Shin, Hanyang University Medical Center
Yuda Turana, Universitas Katolik Indonesia Atma Jaya
Sungha Park, Yonsei University Health System
Kelvin Tsoi, Chinese University of Hong Kong
Chen Huan Chen, National Yang-Ming University Taiwan
Hao Min Cheng, National Yang-Ming University Taiwan
Yan Li, Shanghai Jiao Tong University School of Medicine
Huynh Van Minh, University Medicine and Pharmacy, Hue University
Michiaki Nagai, Hiroshima City Asa Citizens Hospital
Jennifer Nailes, University of the East Ramon Magsaysay Memorial Medical Center
Jorge Sison, De La Salle Medical and Health Sciences Institute
Arieska Ann Soenarta, Universitas Indonesia
Guru Prasad Sogunuru, Madras Institute of Orthopaedics and Traumatology Hospitals
Apichard Sukonthasarn, Chiang Mai University
Jam Chin Tay, Tan Tock Seng Hospital
Boon Wee Teo, Department of Medicine
Narsingh Verma, King George's Medical University
Tzung Dau Wang, National Taiwan University Hospital
Satoshi Hoshide, Jichi Medical University
Kazuomi Kario, Jichi Medical University
Jiguang Wang, Shanghai Jiao Tong University School of Medicine

Abstract

Cardiovascular disease (CVD) is becoming the most important burden to health care systems in most part of the world, especially in Asia. Aiming at identifying high risk individuals and tailoring preventive treatment, many cardiovascular risk assessment tools have been established and most of them were developed in Western countries. However, these cardiovascular risk assessment tools cannot be used interchangeably without recalibration because of the different risk factor profiles (ie, greater absolute burden of hypertension and lower level of total-cholesterol in Asians and higher prevalence of metabolic disorders in South Asians) and different CVD profiles (higher ratio of stroke/coronary heart disease in Asians) between Western and Asian populations. Original risk models such as Prediction for ASCVD Risk in China (China-PAR) and Japan Arteriosclerosis Longitudinal Study (JALS) score have been developed and well validated for specific countries, while most of countries/regions in Asia are using established models. Due to higher incidence of stroke in Asians, risk factors like hypertension should weigh more in cardiovascular risk assessment comparing with Western populations, but their actual proportions should be based on CVD profiles in specific countries/regions. The authors encourage the development of new cardiovascular risk assessment tools for Asians, if possible. Still, modifying established models with native epidemiological data of risk factor as well as CVD is acceptable in regions where health care resources are insufficient.