Percentiles of predicted 10-year cardiovascular disease risk by sex and age in Brazil and their association with estimated risk of long-term atherosclerotic events

Fernando Yue Cesena; Giuliano Generoso; Itamar de S Santos; Bruce B Duncan; Antonio Luiz P Ribeiro; Luisa Caldeira Brant; Jose Geraldo Mill; Alexandre C Pereira; Marcio Sommer Bittencourt; Raul D Santos; Paulo A Lotufo; Isabela M Benseñor

doi:10.1016/j.ypmed.2023.107755

Percentiles of predicted 10-year cardiovascular disease risk by sex and age in Brazil and their association with estimated risk of long-term atherosclerotic events

Prev Med. 2023 Dec:177:107755. doi: 10.1016/j.ypmed.2023.107755. Epub 2023 Nov 4.

Affiliations

¹ Cenocor, Guarulhos, SP, Brazil. Electronic address: cesenaf@gmail.com.
² Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, SP, Brazil.
³ School of Medicine and Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
⁴ Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
⁵ Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
⁶ Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
⁷ Laboratory of Genetics and Molecular Cardiology (LIM13), University of São Paulo Medical School Hospital, São Paulo, SP, Brazil; Genetics Department, Harvard Medical School, Boston, MA, USA.
⁸ Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁹ Heart Institute (InCor), University of São Paulo Medical School Hospital, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

PMID: 37931661
DOI: 10.1016/j.ypmed.2023.107755

Abstract

Objective: Expressing the cardiovascular disease (CVD) risk in relation to peers may complement the estimation of absolute CVD risk. We aimed to determine 10-year CVD risk percentiles by sex and age in the Brazilian population and evaluate their association with estimated long-term atherosclerotic CVD (ASCVD) risk.

Methods: A cross-sectional analysis of baseline data from the ELSA-Brasil study was conducted in individuals aged 40-74 years without prior ASCVD. Ten-year CVD risk and long-term ASCVD risk were estimated by the WHO risk score and the Multinational Cardiovascular Risk Consortium tool, respectively. Ten-year risk percentiles were determined by ranking the calculated risks within each sex and age group.

Results: Ten-year CVD risk versus percentile plots were constructed for each sex and age group using data from 13,364 participants (55% females; median age, 52 [IQR, 46-59] years). Long-term ASCVD risk was calculated in 12,973 (97.1%) participants. Compared to individuals at the <25^th risk percentile, those at the ≥75^th percentile had a greater risk of being in the highest quartile of long-term risk (ORs [95% CIs] 6.57 [5.18-8.30] in females and 11.59 [8.42-15.96] in males) in regression models adjusted for age, race, education, and 10-year CVD risk. In both sexes, the association between risk percentile and long-term risk weakened after age 50. A tool for calculating 10-year CVD risk and the corresponding percentile is available at https://bit.ly/3CzPUi6.

Conclusions: We established percentiles of predicted 10-year CVD risk by sex and age in the Brazilian population, which independently reflect the estimated long-term ASCVD risk in younger individuals.

Keywords: ASCVD; Awareness; Cardiovascular diseases; Heart disease risk factors; Risk assessment; World Health Organization.

MeSH terms

Atherosclerosis* / epidemiology
Brazil / epidemiology
Cardiovascular Diseases* / epidemiology
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Risk Assessment
Risk Factors