Cardiovascular Risk Assessment in Developing World

Many international and national authorities recommend that cardiovascular risk assessment using multivariate risk scores be used to identify individuals at high risk of cardiovascular disease (CVD). This approach is likely to assure that resources in developing countries are allocated to those who need it most. However, not many developing countries have implemented this approach and different countries have varying progresses in adopting the concept. While many developing countries solely described estimated cardiovascular risk by applying existing CVD risk scores to their population’s cross-sectional data, a number of countries have validated and recalibrated existing risk scores and only a few have developed new risk scores specific to their populations. To enhance the adoption of such a policy in developing countries, new CVD risk prediction charts for lowand medium-resource settings were developed and endorsed by the WHO and International Society of Hypertension. However, a number of issues need to be addressed, including development of population-specific risk scores, recalibration of available risk scores and uncertainty over cost-effectiveness of CVD risk assessment in developing countries. Although this high risk approach might represent an effective and practical strategy for developing countries, a complementary population-based approach is also needed to maximize benefits for CVD prevention.