ArticleThe Lancet regional health. Western Pacific2021
Validating World Health Organization cardiovascular disease risk charts and optimizing risk assessment in China.
Article in The Lancet regional health. Western Pacific, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review.Open heart · 2025Pooled it
- A Systematic Review and Meta-Analysis of the Predictive Power of China-PAR Against Cardiovascular Disease.Clinical medicine & research · 2024Pooled it
- Pooled it
- Cardiovascular disease risk prediction models in the Chinese population- a systematic review and meta-analysis.BMC public health · 2022Pooled it
- Effectiveness of a Primary-Care-Centered Integrated Care Intervention for Stratified Cardiovascular Risk Control in China: Study Protocol for a Pragmatic Cluster Randomized Controlled Trial.Health care science · 2026Article
- Association between disease activity, arterial stiffness, and 10-year cardiovascular risk in patients with rheumatoid arthritis: a cross-sectional study.Rheumatology international · 2026Article
- Comparing Non-Laboratory-Based and Laboratory-Based Cardiovascular Risk Predictions: Systematic Review and Meta-Analysis.Health science reports · 2026Review
- Body mass index modifies cardiovascular risk trajectory: a Chinese longitudinal cohort study.BMC public health · 2026Article
- Machine learning increases the prediction of stroke for Chinese hypertensive patients.Frontiers in microbiology · 2026Article
- Integrating epidemiologic modeling and explainable machine learning to evaluate body roundness index for WHO-defined high cardiovascular risk: evidence from the ChinaHEART-Luohe screening cohort.Frontiers in nutrition · 2026Article
- Article
- Comparative evaluation of ASCVD, SCORE-2, and HEARTS risk scores in Colombian adults at risk of type 2 diabetes: stratification, concordance, and associated factors.Frontiers in cardiovascular medicine · 2025Article
- Enhanced cardiovascular risk prediction in the Western Pacific: A machine learning approach tailored to the Malaysian population.PloS one · 2025Article
- Comparison of Laboratory and Non-Laboratory-Based 2019 World Health Organization Cardiovascular Risk Charts in the Bhutanese Population.Asia-Pacific journal of public health · 2024Article
- Association between myocardial layer-specific strain and high 10-year risk of atherosclerotic cardiovascular disease in hypertension-findings from the China-PAR project study.Frontiers in cardiovascular medicine · 2024Article
- Cardiovascular risk assessment: The key path toward precision prevention.Chronic diseases and translational medicine · 2023Article
- Laboratory-based versus non-laboratory-based World Health Organization risk equations for assessment of cardiovascular disease risk.BMC medical research methodology · 2023Article
- Validation of the general Framingham Risk Score (FRS), SCORE2, revised PCE and WHO CVD risk scores in an Asian population.The Lancet regional health. Western Pacific · 2023Article
- WHO cardiovascular disease risk prediction model performance in 10 regions, China.Bulletin of the World Health Organization · 2023Article
- Increased arterial pressure volume index and cardiovascular risk score in China.BMC cardiovascular disorders · 2023Article
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWorld Health Organization (WHO) released region-specific cardiovascular disease (CVD) risk prediction charts recently, but the extent to which the charts can apply to Chinese population is unknown. We aimed to validate the WHO CVD risk charts for East Asia, and evaluate their practicability combining with China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) equations among Chinese adults.
methodsThe China-PAR cohort with 93,234 participants aged 40-80 years was followed up during 1992-2015, including 29,337 participants from three sub-cohorts with follow-up period of over 10 years. We validated the WHO CVD risk charts using the China-PAR cohort by assessment of the predicted number of events, C index, calibration χ², and calibration plots, further elaborated the concordance between the China-PAR equations and the WHO risk charts.
findingsDuring an average follow-up of 13•64 years, 1849 incident CVD cases were identified from 29,337 participants. Both the laboratory-based and non-laboratory-based charts overestimated CVD events by 59% and 58% in men, and by 72% and 85% in women, respectively. However, 92% of participants identified as high risk by the China-PAR equations could be successfully detected by the laboratory-based charts at the cut-off point of 10%. We also observed that the non-laboratory-based charts demonstrated the poor performance for diabetic population, with high proportion of high-risk individuals (17% for men, 31% for women) would be missed.
interpretationAlthough the WHO CVD risk charts for East Asia apparently overestimated CVD risk among Chinese population, they could be pragmatic pre-selection tools, as potential supplement to the China-PAR equations. The widespread use of the WHO risk charts along with the China-PAR equations might facilitate the implementation of the risk-based CVD prevention in China.
fundingFull funding sources are listed at the end of the paper (see Acknowledgments).
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