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@ARTICLE{Group:147203,
author = {S. Kaptoge and L. Pennells and D. De Bacquer and M. T.
Cooney and M. Kavousi and G. Stevens and L. M. Riley and S.
Savin and T. Khan and S. Altay and P. Amouyel and G. Assmann
and S. Bell and Y. Ben-Shlomo and L. Berkman and J. W.
Beulens and C. Björkelund and M. Blaha and D. G. Blazer and
T. Bolton and R. Bonita Beaglehole and H. Brenner$^*$ and E.
J. Brunner and E. Casiglia and P. Chamnan and Y.-H. Choi and
R. Chowdry and S. Coady and C. J. Crespo and M. Cushman and
G. R. Dagenais and R. B. D'Agostino and M. Daimon and K. W.
Davidson and G. Engström and I. Ford and J. Gallacher and
R. T. Gansevoort and T. A. Gaziano and S. Giampaoli and G.
Grandits and S. Grimsgaard and D. E. Grobbee and V. Gudnason
and Q. Guo and H. Tolonen and S. Humphries and H. Iso and J.
W. Jukema and J. Kauhanen and A. P. Kengne and D. Khalili
and W. Koenig and D. Kromhout and H. Krumholz and T. H. Lam
and G. Laughlin and A. Marín Ibañez and T. W. Meade and K.
G. M. Moons and P. J. Nietert and T. Ninomiya and B. G.
Nordestgaard and C. O'Donnell and L. Palmieri and A. Patel
and P. Perel and J. F. Price and R. Providencia and P. M.
Ridker and B. Rodriguez and A. Rosengren and R. Roussel and
M. Sakurai and V. Salomaa and S. Sato and B. Schöttker$^*$
and N. Shara and J. E. Shaw and H.-C. Shin and L. A. Simons
and E. Sofianopoulou and J. Sundström and H. Völzke and R.
B. Wallace and N. J. Wareham and P. Willeit and D. Wood and
A. Wood and D. Zhao and M. Woodward and G. Danaei and G.
Roth and S. Mendis and O. Onuma and C. Varghese and M.
Ezzati and I. Graham and R. Jackson and J. Danesh and E. Di
Angelantonio},
collaboration = {W. C. R. C. W. Group},
title = {{W}orld {H}ealth {O}rganization cardiovascular disease risk
charts: revised models to estimate risk in 21 global
regions.},
journal = {The lancet / Global health Global health [...]},
volume = {7},
number = {10},
issn = {2214-109X},
address = {Oxford},
publisher = {Elsevier},
reportid = {DKFZ-2019-02329},
pages = {e1332 - e1345},
year = {2019},
abstract = {To help adapt cardiovascular disease risk prediction
approaches to low-income and middle-income countries, WHO
has convened an effort to develop, evaluate, and illustrate
revised risk models. Here, we report the derivation,
validation, and illustration of the revised WHO
cardiovascular disease risk prediction charts that have been
adapted to the circumstances of 21 global regions.In this
model revision initiative, we derived 10-year risk
prediction models for fatal and non-fatal cardiovascular
disease (ie, myocardial infarction and stroke) using
individual participant data from the Emerging Risk Factors
Collaboration. Models included information on age, smoking
status, systolic blood pressure, history of diabetes, and
total cholesterol. For derivation, we included participants
aged 40-80 years without a known baseline history of
cardiovascular disease, who were followed up until the first
myocardial infarction, fatal coronary heart disease, or
stroke event. We recalibrated models using age-specific and
sex-specific incidences and risk factor values available
from 21 global regions. For external validation, we analysed
individual participant data from studies distinct from those
used in model derivation. We illustrated models by analysing
data on a further 123 743 individuals from surveys in 79
countries collected with the WHO STEPwise Approach to
Surveillance.Our risk model derivation involved 376 177
individuals from 85 cohorts, and 19 333 incident
cardiovascular events recorded during 10 years of follow-up.
The derived risk prediction models discriminated well in
external validation cohorts (19 cohorts, 1 096 061
individuals, 25 950 cardiovascular disease events), with
Harrell's C indices ranging from 0·685 $(95\%$ CI
0·629-0·741) to 0·833 (0·783-0·882). For a given risk
factor profile, we found substantial variation across global
regions in the estimated 10-year predicted risk. For
example, estimated cardiovascular disease risk for a
60-year-old male smoker without diabetes and with systolic
blood pressure of 140 mm Hg and total cholesterol of 5
mmol/L ranged from $11\%$ in Andean Latin America to $30\%$
in central Asia. When applied to data from 79 countries
(mostly low-income and middle-income countries), the
proportion of individuals aged 40-64 years estimated to be
at greater than $20\%$ risk ranged from less than $1\%$ in
Uganda to more than $16\%$ in Egypt.We have derived,
calibrated, and validated new WHO risk prediction models to
estimate cardiovascular disease risk in 21 Global Burden of
Disease regions. The widespread use of these models could
enhance the accuracy, practicability, and sustainability of
efforts to reduce the burden of cardiovascular disease
worldwide.World Health Organization, British Heart
Foundation (BHF), BHF Cambridge Centre for Research
Excellence, UK Medical Research Council, and National
Institute for Health Research.},
cin = {C070 / C120},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331},
pnm = {323 - Metabolic Dysfunction as Risk Factor (POF3-323)},
pid = {G:(DE-HGF)POF3-323},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:31488387},
doi = {10.1016/S2214-109X(19)30318-3},
url = {https://inrepo02.dkfz.de/record/147203},
}