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Pooled Cohort Equation identifies more black patients with CVD risk
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The Pooled Cohort Equation from the American College of Cardiology/American Heart Association cholesterol guidelines estimated more black patients with subclinical vascular disease compared with the Framingham risk score, according to a study published in The American Journal of Cardiology.
Matthew L. Topel, MD, MSc, clinical research fellow in the division of cardiology at Emory University School of Medicine, and colleagues analyzed data from 1,231 patients (mean age, 53 years; 59% women) without a known history of CVD and who were either black (n = 452) or white (n = 779). Information including demographic data, BP measurements, smoking status, blood samples and history of diabetes, hypertension and dyslipidemia was used to calculate the Framingham and atherosclerotic CVD risk scores.
Arterial stiffness was determined through central pulse pressure, pulse wave velocity and central augmentation index. Carotid intima-media thickness was measured for subclinical atherosclerosis.
Black patients were more likely to have higher central pulse pressure (36.4 mm Hg vs. 34.9 mm Hg; P = .014), central augmentation index (23.9% vs. 22.1%; P = .004), carotid intima-media thickness (0.67 mm vs. 0.65 mm; P = .005) and pulse wave velocity (7.6 m/s vs. 7.3 m/s; P = .004) compared with white patients.
Race was an independent predictor of central pulse pressure, central augmentation index, carotid intima-media thickness and pulse wave velocity in a multivariable analysis that included the study cohort, race and the Framingham risk score. When the study cohort, race and Pooled Cohort Equation score were analyzed, race was no longer a significant predictor of subclinical vascular disease.
“The benefit of the ASCVD risk calculator in not underestimating CVD risk in blacks also extends to measures of subclinical vascular disease,” Topel and colleagues wrote. “Use of the ASCVD score rather than the [Framingham risk score] is likely to enable better prediction of subclinical and clinical CVD risk.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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