ArticleThe Lancet. Digital health2022
Differences in estimates for 10-year risk of cardiovascular disease in Black versus White individuals with identical risk factor profiles using pooled cohort equations: an in silico cohort study.
Article in The Lancet. Digital health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Forensic Perspective of Unintentional Doping, Cardiovascular Health, and the Role of Nutrition in Competitive Sports.Nutrients · 2026Pooled it
- Examining the feasibility and acceptability of a six-week at-home physical activity intervention with a focus on strength training for Black women: a randomized controlled trial.BMC women's health · 2026Trial
- Using PREVENT Equations to Compare Intensive vs Standard Systolic Blood Pressure Control for Primary Prevention in SPRINT.Journal of the American College of Cardiology · 2025Trial
- Evaluating algorithmic fairness in the performance of the AHA PREVENT equations versus pooled cohort equations among single-race and multiracial populations.American journal of preventive cardiology · 2026Article
- Associations Between B-Cell Subsets and Subclinical Coronary Artery Disease in Ugandans With and Without HIV.Open forum infectious diseases · 2026Article
- Statin Eligibility Disparities with Transition from the Pooled Cohort Equations to the AHA PREVENT.medRxiv : the preprint server for health sciences · 2026Article
- Atherosclerotic Cardiovascular Disease Risk Estimates Using the New Predicting Risk of Cardiovascular Disease Events Equations: Implications for Statin Use.Current cardiology reports · 2025Review
- Development and Validation of a Simple Model to Predict Patient Height.medRxiv : the preprint server for health sciences · 2025Article
- Precision Medicine in Cardiovascular Disease Prevention: Clinical Validation of Multi-Ancestry Polygenic Risk Scores in a U.S. Cohort.Nutrients · 2025Article
- Artificial intelligence bias in the prediction and detection of cardiovascular disease.NPJ cardiovascular health · 2024Review
- Risk of Cardiovascular Events in Adults Aged 40 to 79 Years with Diagnosed Hypertension, High Cholesterol, and/or Diabetes but Not on Medications: Findings from Nationwide Cross-Sectional Studies.Journal of cardiovascular development and disease · 2024Article
- Collecting Sociodemographic Data in Pediatric Emergency Research: A Working Group Consensus.Pediatrics · 2024Article
- Article
- Performance of contemporary cardiovascular risk stratification scores in Brazil: an evaluation in the ELSA-Brasil study.Open heart · 2024Article
- Vascular health years after a hypertensive disorder of pregnancy: The EPOCH study.American heart journal · 2024Article
- Article
- Impact of Race on Classification of Atherosclerotic Risk Using a National Cardiovascular Risk Prediction Tool.AJPM focus · 2024Article
- The heart-mind relationship in women cardiovascular primary prevention: the role of depression, anxiety, distress and Type-D personality in the 10-years cardiovascular risk evaluation.Frontiers in cardiovascular medicine · 2024Article
- Metabolic and cardiovascular disease risk for Zimbabwean men with prostate cancer receiving long-term androgen deprivation therapy.Research square · 2023Article
- Disparities in Guideline-Recommended Statin Use for Prevention of Atherosclerotic Cardiovascular Disease by Race, Ethnicity, and Gender : A Nationally Representative Cross-Sectional Analysis of Adults in the United States.Annals of internal medicine · 2023Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundSex-specific and race-specific pooled cohort equations (PCEs) are recommended for estimating the 10-year risk of cardiovascular disease, with an absolute risk of more than 7·5% indicating a clinical decision threshold. We compared differences between Black and White individuals in PCE-estimated absolute cardiovascular disease risk across various plausible risk factor combinations with the aim of evaluating if using the PCE might result in different clinical decisions in Black versus White individuals with identical risk profiles.
methodsWe generated in silico patient risk profiles by combining numerical risk factors (age [5-year intervals], total cholesterol [20-mg/dl intervals], HDL cholesterol [5-mg/dl intervals], systolic blood pressure [10-mm Hg intervals]) and binary risk factors (smoking, diabetes, and antihypertensive treatment). We compared PCE-estimated 10-year cardiovascular disease risk in Black versus White individuals with identical risk profiles. We did similar comparisons using eligible participants in the Framingham Heart Study (FHS) third generation cohort and the National Health and Nutrition Examination Survey (NHANES) 2017-18.
findingsFor our in silico analysis, we evaluated 29 515 risk factor combinations for women and 30 565 for men, after excluding profiles that generated 10-year cardiovascular disease risk estimates below 1% or above 30%. There were 6357 risk profiles associated with 10-year cardiovascular disease risk above 7·5% for Black men but not for White men (median risk difference [RD] 6·25%, range 0·15-22·8; median relative risk [RR] 2·40, range 1·02-12·6). There were 391 profiles with 10-year cardiovascular disease risk above 7·5% for White men but not Black men (median RD 2·68%, range 0·07-16·9%; median RR 1·42, range 1·01-3·57). There were 6543 risk profiles associated with 10-year estimated cardiovascular disease risk above 7·5% for Black women but not for White women (median RD 6·14%, range 0·35-26·8%; median RR 2·29, range 1·05-12·6). There were 318 profiles with 10-year cardiovascular disease risk above 7·5% for White women but not Black women (median RD 3·71%, range 0·22-20·1%; median RR 1·66, range 1·03-5·46). For the population-based samples, we calculated the PCE-based 10-year cardiovascular disease risk for 1272 eligible participants (378 women; median age 48 years [IQR 44-52]; 100% White) in the FHS third generation cohort and 550 participants (223 women [36·8% Black] and 327 men [40·4% Black]; median age 61 years [IQR 52-67]) in the NHANES cohort. The population-based samples showed similar risk differences to that of the in silico analyses.
interpretationThe PCE might generate substantially divergent cardiovascular disease risk estimates for Black versus White individuals with identical risk profiles, which could introduce race-related variations in clinical recommendations for cardiovascular disease prevention.
fundingUS National Institutes of Health.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.