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A Simple Model for Predicting 10-Year Cardiovascular Risk in Middle-Aged to Older Chinese: Guangzhou Biobank Cohort Study

Abstract

The aim of this paper is to develop 10-year cardiovascular disease (CVD) risk prediction models for the contemporary Chinese populations based on the Guangzhou Biobank Cohort Study (GBCS) and to compare its performance with models based on Framingham’s general cardiovascular risk profile and the Prediction for Atherosclerotic CVD Risk in China (China-PAR) project. Subjects were randomly classified into the training (n = 15,000) and validation (n = 12,721) sets. During an average of 12.0 years’ follow-up, 3,732 CVD events occurred. A 10-year sex-specific CVD risk prediction model including age, systolic blood pressure, use of antihypertensive medication, smoking, and diabetes was developed. Compared with the Framingham and China-PAR models, the GBCS model had a better discrimination in both women (c-statistic 0.72, 95% CI 0.71–0.73) and men (c-statistic 0.68, 95% CI 0.67–0.70), and the risk predicted was closer to the actual risk. This prediction model would be useful for identifying individuals at higher risks of CVD in contemporary Chinese populations.

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Data Availability

The datasets analyzed during the current study are not publicly available due to the protection of the privacy of the participants but are available from the corresponding author on reasonable request.

Abbreviations

CVD:

Cardiovascular disease

ASCVD:

Atherosclerotic cardiovascular disease

CHD:

Coronary heart disease

GBCS:

Guangzhou Biobank Cohort Study

China-PAR:

Prediction for ASCVD Risk in China

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

BMI:

Body mass index

LDL:

Low-density lipoprotein

HDL:

High-density lipoprotein

AUC:

Area under curve

ROC:

Receiver operating characteristic

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Acknowledgements

The Guangzhou Biobank Cohort Study investigators include the following: Guangzhou Twelfth People’s Hospital, WS Zhang, M Cao, T Zhu, B Liu, and CQ Jiang (Co-PI); The University of Hong Kong, CM Schooling, SM McGhee, GM Leung, R Fielding, and TH Lam (Co-PI); and The University of Birmingham, P Adab, GN Thomas, and KK Cheng (Co-PI).

Funding

This work was funded by the Natural Science Foundation of China (No. 81941019), the Major Infectious Disease Prevention and Control of the National Science and Technique Major Project (2018ZX10715004), the National Key R&D Program of China (2017YFC0907100), the Natural Science Foundation of Guangdong (2018A030313140), the Guangzhou Science and Technology Bureau (201704030132), and the University of Birmingham, UK.

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Contributions

Ying Yue Huang, Wen Bo Tian, Chao Qiang Jiang, Wei Sen Zhang, Feng Zhu, Ya Li Jin, Tai Hing Lam, Lin Xu, and Kar Keung Cheng have substantial contributions to conception and design, acquisition of funding and data, and interpretation of data; YYH, THL, and LX analyzed the data; WBT, LX, and KKC drafted the article; YYH, WBT, THL, LX, and KKC revised it critically for important intellectual content; and all authors contributed to final approval of the paper.

Corresponding authors

Correspondence to Chao Qiang Jiang, Tai Hing Lam or Lin Xu.

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The Guangzhou Medical Ethics Committee of the Chinese Medical Association approved the study, and all participants gave written, informed consent before participation.

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The authors declare no competing interests.

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Communicated by Associate Editor Junjie Xiao oversaw the review of this article.

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Cite this article

Huang, Y.Y., Tian, W.B., Jiang, C.Q. et al. A Simple Model for Predicting 10-Year Cardiovascular Risk in Middle-Aged to Older Chinese: Guangzhou Biobank Cohort Study. J. of Cardiovasc. Trans. Res. (2021). https://doi.org/10.1007/s12265-021-10163-3

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Keywords

  • Cardiovascular disease
  • Risk assessment
  • Prediction model
  • Primary prevention