Sex differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population
Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, for which various risk engines have been develop...
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| creator | Lim, Hee-Sook Han, Hyein Won, Sungho Ji, Sungin Park, Yoonhyung Lee, Hae-Young |
| description | Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, for which various risk engines have been developed. The important keys to CVD risk engines are high reliability and accuracy, which show differences in predictability depending on disease status or race. Framingham risk score (FRS) and the atherosclerotic cardiovascular disease risk equations (ASCVD) were applied to the Korean population to assess their suitability.
A retrospective cohort study was conducted using National Health Insurance Corporation sample cohort from 2003 to 2015. The enrolled participants over 30 years of age and without CVD followed-up for 10 years. We compared the prediction performance of FRS and ASCVD and calculated the relative importance of each covariate.
The AUCs of FRS (men: 0.750; women: 0.748) were higher than those of ASCVD (men: 0.718; women: 0.727) for both sexes (Delong test P |
| doi_str_mv | 10.1371/journal.pone.0292067 |
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A retrospective cohort study was conducted using National Health Insurance Corporation sample cohort from 2003 to 2015. The enrolled participants over 30 years of age and without CVD followed-up for 10 years. We compared the prediction performance of FRS and ASCVD and calculated the relative importance of each covariate.
The AUCs of FRS (men: 0.750; women: 0.748) were higher than those of ASCVD (men: 0.718; women: 0.727) for both sexes (Delong test P <0.01). Goodness of fits (GOF) were poor for all models (Chi-square P < 0.001), especially, underestimation of the risk was pronounced in women. When the men's coefficients were applied to women's data, AUC (0.748; Delong test P<0.01) and the GOF (chi-square P = 0.746) were notably improved in FRS. Hypertension was found to be the most influential variable for CVD, and this is one of the reasons why FRS, having the highest relative weight to blood pressure, showed better performance.
When applying existing tools to Korean women, there was a noticeable underestimation. To accurately predict the risk of CVD, it was more appropriate to use FRS with men's coefficient in women. Moreover, hypertension was found to be a main risk factor for CVD.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0292067</identifier><identifier>PMID: 38295132</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Arteriosclerosis ; Atherosclerosis ; Atherosclerosis - epidemiology ; Blood pressure ; Body mass index ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Chi-square test ; Cholesterol ; Chronic illnesses ; Data collection ; Demographic aspects ; Diabetes ; Diagnosis ; Engines ; Female ; Gender differences ; Health risks ; Heart ; High density lipoprotein ; Humans ; Hypertension ; Hypertension - epidemiology ; Ischemia ; Low density lipoprotein ; Male ; Mathematical models ; Medical screening ; Medicine and Health Sciences ; Men ; National health insurance ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sex Characteristics ; Sex differences ; Sexes ; Stroke ; Triglycerides ; Women ; Womens health</subject><ispartof>PloS one, 2024-01, Vol.19 (1), p.e0292067-e0292067</ispartof><rights>Copyright: © 2024 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Lim et al 2024 Lim et al</rights><rights>2024 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-515f5371c5f03624239a62033d2e0ffe189c43be30fb6e2f5c45246862a12c5b3</cites><orcidid>0000-0003-0745-8906 ; 0000-0002-6875-7320 ; 0000-0002-9521-4102</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830057/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10830057/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38295132$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lim, Hee-Sook</creatorcontrib><creatorcontrib>Han, Hyein</creatorcontrib><creatorcontrib>Won, Sungho</creatorcontrib><creatorcontrib>Ji, Sungin</creatorcontrib><creatorcontrib>Park, Yoonhyung</creatorcontrib><creatorcontrib>Lee, Hae-Young</creatorcontrib><title>Sex differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, for which various risk engines have been developed. The important keys to CVD risk engines are high reliability and accuracy, which show differences in predictability depending on disease status or race. Framingham risk score (FRS) and the atherosclerotic cardiovascular disease risk equations (ASCVD) were applied to the Korean population to assess their suitability.
A retrospective cohort study was conducted using National Health Insurance Corporation sample cohort from 2003 to 2015. The enrolled participants over 30 years of age and without CVD followed-up for 10 years. We compared the prediction performance of FRS and ASCVD and calculated the relative importance of each covariate.
The AUCs of FRS (men: 0.750; women: 0.748) were higher than those of ASCVD (men: 0.718; women: 0.727) for both sexes (Delong test P <0.01). Goodness of fits (GOF) were poor for all models (Chi-square P < 0.001), especially, underestimation of the risk was pronounced in women. When the men's coefficients were applied to women's data, AUC (0.748; Delong test P<0.01) and the GOF (chi-square P = 0.746) were notably improved in FRS. Hypertension was found to be the most influential variable for CVD, and this is one of the reasons why FRS, having the highest relative weight to blood pressure, showed better performance.
When applying existing tools to Korean women, there was a noticeable underestimation. To accurately predict the risk of CVD, it was more appropriate to use FRS with men's coefficient in women. Moreover, hypertension was found to be a main risk factor for CVD.</description><subject>Adult</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis - epidemiology</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Chi-square test</subject><subject>Cholesterol</subject><subject>Chronic illnesses</subject><subject>Data collection</subject><subject>Demographic aspects</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Engines</subject><subject>Female</subject><subject>Gender differences</subject><subject>Health risks</subject><subject>Heart</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - epidemiology</subject><subject>Ischemia</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medical screening</subject><subject>Medicine and Health Sciences</subject><subject>Men</subject><subject>National health insurance</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sex Characteristics</subject><subject>Sex differences</subject><subject>Sexes</subject><subject>Stroke</subject><subject>Triglycerides</subject><subject>Women</subject><subject>Womens 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differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population</title><author>Lim, Hee-Sook ; Han, Hyein ; Won, Sungho ; Ji, Sungin ; Park, Yoonhyung ; Lee, Hae-Young</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-515f5371c5f03624239a62033d2e0ffe189c43be30fb6e2f5c45246862a12c5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Atherosclerosis - epidemiology</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Chi-square test</topic><topic>Cholesterol</topic><topic>Chronic illnesses</topic><topic>Data collection</topic><topic>Demographic 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Hee-Sook</au><au>Han, Hyein</au><au>Won, Sungho</au><au>Ji, Sungin</au><au>Park, Yoonhyung</au><au>Lee, Hae-Young</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-01-31</date><risdate>2024</risdate><volume>19</volume><issue>1</issue><spage>e0292067</spage><epage>e0292067</epage><pages>e0292067-e0292067</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, for which various risk engines have been developed. The important keys to CVD risk engines are high reliability and accuracy, which show differences in predictability depending on disease status or race. Framingham risk score (FRS) and the atherosclerotic cardiovascular disease risk equations (ASCVD) were applied to the Korean population to assess their suitability.
A retrospective cohort study was conducted using National Health Insurance Corporation sample cohort from 2003 to 2015. The enrolled participants over 30 years of age and without CVD followed-up for 10 years. We compared the prediction performance of FRS and ASCVD and calculated the relative importance of each covariate.
The AUCs of FRS (men: 0.750; women: 0.748) were higher than those of ASCVD (men: 0.718; women: 0.727) for both sexes (Delong test P <0.01). Goodness of fits (GOF) were poor for all models (Chi-square P < 0.001), especially, underestimation of the risk was pronounced in women. When the men's coefficients were applied to women's data, AUC (0.748; Delong test P<0.01) and the GOF (chi-square P = 0.746) were notably improved in FRS. Hypertension was found to be the most influential variable for CVD, and this is one of the reasons why FRS, having the highest relative weight to blood pressure, showed better performance.
When applying existing tools to Korean women, there was a noticeable underestimation. To accurately predict the risk of CVD, it was more appropriate to use FRS with men's coefficient in women. Moreover, hypertension was found to be a main risk factor for CVD.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38295132</pmid><doi>10.1371/journal.pone.0292067</doi><tpages>e0292067</tpages><orcidid>https://orcid.org/0000-0003-0745-8906</orcidid><orcidid>https://orcid.org/0000-0002-6875-7320</orcidid><orcidid>https://orcid.org/0000-0002-9521-4102</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Arteriosclerosis Atherosclerosis Atherosclerosis - epidemiology Blood pressure Body mass index Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Chi-square test Cholesterol Chronic illnesses Data collection Demographic aspects Diabetes Diagnosis Engines Female Gender differences Health risks Heart High density lipoprotein Humans Hypertension Hypertension - epidemiology Ischemia Low density lipoprotein Male Mathematical models Medical screening Medicine and Health Sciences Men National health insurance Reproducibility of Results Retrospective Studies Risk Assessment Risk Factors Sex Characteristics Sex differences Sexes Stroke Triglycerides Women Womens health |
| title | Sex differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T23%3A24%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Sex%20differences%20in%20the%20applicability%20of%20Western%20cardiovascular%20disease%20risk%20prediction%20equations%20in%20the%20Asian%20population&rft.jtitle=PloS%20one&rft.au=Lim,%20Hee-Sook&rft.date=2024-01-31&rft.volume=19&rft.issue=1&rft.spage=e0292067&rft.epage=e0292067&rft.pages=e0292067-e0292067&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0292067&rft_dat=%3Cgale_plos_%3EA781032823%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3069265468&rft_id=info:pmid/38295132&rft_galeid=A781032823&rft_doaj_id=oai_doaj_org_article_0bb544b7b0d54d139f42d26b02e013b5&rfr_iscdi=true |