Non-lab screening tool to assess cardiovascular diseases risk 85 per cent accurate in Indian set up: Study

Ahmedabad: A non-laboratory-based screening tool to assess the 10-year risk of an individual for developing cardiovascular diseases (CVDs) is found to be 85 per cent accurate in the Indian set-up in the primary stage of a study by Gandhinagar-based Indian Institute of Public Health (IIPH).

The initial findings of the study, being carried out with a grant from the Department of Health Research of the Union Ministry of Health and Family Welfare, brightens the possibility of the adoption of the “Framingham risk assessment tool” as a cost-effective and feasible alternative for largescale screening of patients for CVDs for a resource-limited country like India, said Dr Komal Shah, a biomedical scientist.

“We plan to see how best we can develop the tool for India which does not require a laboratory set up and skilled persons to carry out tests to assess CVD risk. The ultimate aim of the study is to provide frontline workers with this tool so that they can identify people above 30 years of age who fall in the high-risk group,” said Dr Shah.

She also said that cholesterol is not a great indicator of cardiac risks among Indians.
The first phase data of the non-laboratory-based Framingham risk score algorithm to assess 10-year CVD risk and heart age of an individual above 30 years of age has been found to be 85 per cent accurate on around 2,100 participants from Gujarat when compared with the laboratory tool, she said.

It uses parameters like the Body Mass Index (BMI), age, sex, systolic blood pressure, and risk factors like hypertension, smoking, and diabetes. It is available in the electronic format for free and is being used widely by researchers globally for CVD risk assessment, Dr Shah said.

The tool was validated for the population in the US, Canada, Australia and European countries but not for the Indian population, said Dr Shah, an associate professor at IIPH-G.

The validation of the screening tool in the Indian context will help CVD risk assessment among people residing in remote and resource-scarce areas where it is very difficult to get laboratory settings, she said.

“The beauty of this tool is that you get an accurate percentage of risk and not some vague statement,” said Dr Shah.

Based on the score, the risk is accordingly categorised as low, moderate and high. If a person is found to be falling in the high-risk category, he will be required to start primary medication as per the clinical guidelines, she said.

“The tool can help the frontline workers in any corner of the country to identify patients with CVD risk early on. If you identify the people quite early, you can prevent a lot many events later. It can be really important from a preventive perspective as well,” she said.

Dr. Shah said the IIPH-G has also started the study on a sample population of 45,000 from tea estate areas of Assam because the geographical location also plays an important role in assessing the risk factor for CVD. The primary findings of the one-year-long study will be out in a couple of months.

Apart from validating the non-lab-based tool in the Indian context, the study also aims to develop its own tool with different indicators with more accurate results, she said.

“Cholesterol is not a great indicator for cardiac risks among Indians. We are more prone to low levels of good cholesterol. We are different from other populations. They have taken BMI as an indicator for the lab test. For us, it might be something else,” said Dr Shah.

CVD has emerged as a major contributor to mortality and morbidity among Indians and imparts a substantial clinical and economical burden on the population and health system, she said. According to a study, CVDs have become the leading cause of mortality in India with a quarter of all mortality attributable to it.