Skip to main content

Advertisement

SpringerLink
Log in

Cardiovascular Disease Risk Score: Results from the Filipino–American Women Cardiovascular Study

  • Published:
Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Introduction

Although cardiovascular disease (CVD) is a leading cause of morbidity and mortality of Filipino–Americans, conventional CVD risk calculators may not be accurate for this population. CVD risk scores of a group of Filipino–American women (FAW) were measured using the major risk calculators. Secondly, the sensitivity of the various calculators to obesity was determined.

Methods

This is a cross-sectional descriptive study that enrolled 40–65-year-old FAW (n = 236), during a community-based health screening study. Ten-year CVD risk was calculated using the Framingham Risk Score (FRS), Reynolds Risk Score (RRS), and Atherosclerotic Cardiovascular Disease (ASCVD) calculators. The 30-year risk FRS and the lifetime ASCVD calculators were also determined.

Results

Levels of predicted CVD risk varied as a function of the calculator. The 10-year ASCVD calculator classified 12 % of participants with ≥10 % risk, but the 10-year FRS and RRS calculators classified all participants with ≤10 % risk. The 30-year “Hard” Lipid and BMI FRS calculators classified 32 and 43 % of participants with high (≥20 %) risk, respectively, while 95 % of participants were classified with ≥20 % risk by the lifetime ASCVD calculator. The percent of participants with elevated CVD risk increased as a function of waist circumference for most risk score calculators.

Conclusions

Differences in risk score as a function of the risk score calculator indicate the need for outcome studies in this population. Increased waist circumference was associated with increased CVD risk scores underscoring the need for obesity control as a primary prevention of CVD in FAW.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Republic of the Philippines National Statistics Office. Deaths. 2007. Available from: http://web0.psa.gov.ph/content/deaths-philippines-2007

  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Executive summary: heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):143–52.

  3. Rutherford JN, McDade TW, Feranil AB, Adair LS, Kuzawa CW. High prevalence of low HDL-c in the Philippines compared to the US: population differences in associations with diet and BMI. Asia Pac J Clin Nutr. 2010;19(1):57–67.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Cook NR, Paynter NP, Eaton CB, Manson JE, Martin LW, Robinson JG, et al. Comparison of the Framingham and Reynolds Risk scores for global cardiovascular risk prediction in the multiethnic Women’s Health Initiative. Circulation. 2012;125(14):1748–11.

  5. U.S. Census Bureau. The Asian population. 2013. Available from: http://www.census.gov/newsroom/releases/pdf/cb13ff-09_asian.pdf

  6. Ursua RA, Islam NS, Aguilar DE, Wyatt LC, Tandon SD, Abesamis-Mendoza N, et al. Predictors of hypertension among Filipino immigrants in the Northeast US. J Community Health. 2013;38(5):847–55.

  7. Ye J, Rust G, Baltrus P, Daniels E. Cardiovascular risk factors among Asian Americans: results from a National Health Survey. Ann Epidemiol. 2009;19(10):718–23.

    Article  PubMed  Google Scholar 

  8. Holland AT, Wong EC, Lauderdale DS, Palaniappan LP. Spectrum of cardiovascular diseases in Asian-American racial/ethnic subgroups. Ann Epidemiol. 2011;21(8):608–14.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Karter AJ, Schillinger D, Adams AS, Moffet HH, Liu J, Adler NE, et al. Elevated rates of diabetes in Pacific Islanders and Asian subgroups: the Diabetes Study of Northern California (DISTANCE). Diabetes Care. 2013;36(3):574–9.

  10. Choi SE, Liu M, Palaniappan LP, Wang EJ, Wong ND. Gender and ethnic differences in the prevalence of type 2 diabetes among Asian subgroups in California. J Diabetes Complications. 2013;27(5):429–35.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Magno CP, Araneta MR, Macera CA, Anderson GW. Cardiovascular disease prevalence, associated risk factors, and plasma adiponectin levels among Filipino American women. Ethn Dis. 2008;18(4):458–63.

    PubMed  Google Scholar 

  12. Ancheta IB, Battie CA, Tuason T, Ancheta CV. A comparison of metabolic syndrome (MetS) risk factors in Filipino women and Filipino American women: a pilot study. Ethn Dis. 2012;22(4):404–9.

    PubMed  Google Scholar 

  13. Araneta MR, Wingard DL, Barrett-Connor E. Type 2 diabetes and metabolic syndrome in Filipina-American women: a high-risk nonobese population. Diabetes Care. 2002;25(3):494–9.

    Article  PubMed  Google Scholar 

  14. Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.

    Article  CAS  PubMed  Google Scholar 

  15. Pencina MJ, D’Agostino Sr RB, Larson MG, Massaro JM, Vasan RS. Predicting the 30-year risk of cardiovascular disease: the Framingham Heart Study. Circulation. 2009;119(24):3078–84.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007;297(6):611–9.

    Article  CAS  PubMed  Google Scholar 

  17. D’Agostino RB, Sr., Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117(6):743–53.

  18. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Jr., Kastelein JJ, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N EngL J Med. 2008;359(21):2195–207.

  19. Goff DC, Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Sr., Gibbons R, et al. ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25):2935–59.

  20. Tunstall-Pedoe H, Woodward M, Watt G. ASSIGN, QRISK and validation. BMJ. 2009;339:b3514.

    Article  PubMed  Google Scholar 

  21. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ. 2008;336(7659):1475–82.

  22. Zhang XF, Attia J, D’Este C, Yu XH, Wu XG. A risk score predicted coronary heart disease and stroke in a Chinese cohort. J Clin Epidemiol. 2005;58(9):951–8.

    Article  PubMed  Google Scholar 

  23. Menotti A, Lanti M, Agabiti-Rosei E, Carratelli L, Cavera G, Dormi A, et al. New tools for prediction of cardiovascular disease risk derived from Italian population studies. Nutr Metab Cardiovasc Dis. 2005;15(6):426–40.

  24. Conroy R, Pyorala K, Fitzgerald A, Sans S, Menotti A, De B, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24(11):987–1003.

  25. Rao G, Powell-Wiley TM, Ancheta I, Hairston K, Kirley K, Lear SA, et al. Identification of obesity and cardiovascular risk in ethnically and racially diverse populations: a scientific statement from the American Heart Association. Circulation. 2015;132(5):457–72. doi:10.1161/CIR.0000000000000223.

  26. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ. 2007;335(7611):1–12.

    Article  Google Scholar 

  27. Ancheta IB, Carlson JM, Battie CA, Borja-Hart N, Cobb S, Ancheta CV. One size does not fit all: cardiovascular health disparities as a function of ethnicity in Asian-American women. Appl Nurs. 2015;28(2):99–105.

  28. Zhao B, Jose PO, Pu J, Chung S, Ancheta IB, Fortmann SP, et al. Racial/ethnic differences in hypertension prevalence, treatment, and control for outpatients in northern California 2010–2012. Am J Hypertens. 2015;28(5):631–9.

  29. Staiano AE, Reeder BA, Elliott S, Joffres MR, Pahwa P, Kirkland SA, et al. Body mass index versus waist circumference as predictors of mortality in Canadian adults. Int J Obes (Lond). 2012;36(11):1450–4.

  30. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359(20):2105–20.

  31. Ancheta IB, Battie C, Tuason T, Borja-Hart N, Ancheta CV, et al. The prevalence of cardiovascular risk factors and diabetes increases with a body mass index of > or = 23 kg/m2 in Filipino American women. Ethn Dis. 2014;24(1):48–54.

  32. Heo M, Faith M, Pietrobelli A, Heymfield SB. Percentage of body fat cutoffs by sex, age, and race-ethnicity in the US adult population from NHANES 1999–2004. Am J Clin Nutr. 2012;95(3):594–602.

  33. Rush E, Goedecke J, Jennings C, Micklesfield L, Dugas L, Lambert EV. BMI fat and muscle differences in urban women of five ethnicities from two countries. Int J Obes (Lond). 2007;31(8):1232–9.

  34. Yang EY, Nambi V, Tang Z, Virani S, Boerwinkle E, Hoogeveen R, et al. Clinical implications of JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) in a U.S. population insights from the ARIC (Atherosclerosis Risk in Communities) study. J Am Coll Cardiol. 2009;54(25):2388–95.

  35. Palaniappan L, Araneta MR, Assimes T, Barrett-Connor EL, Carnethon MR, Criqui MH, et al. Call to action: cardiovascular disease in Asian Americans: a science advisory from the American Heart Association. Circulation. 2010;122(12):1242–52.

  36. Woodward M, Brindle P, Tunstall-Pedoe H. Adding social deprivation and family history to cardiovascular risk assessment: the ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart. 2007;93(2):172–6.

    Article  PubMed  Google Scholar 

  37. Salinas JJ, Abdelbary B, Wilson J, Hossain M, Fisher-Hoch S, McCormick J. Using the FRS to evaluate immigrant effect on cardiovascular disease risk in Mexican Americans. J Health Care Poor Underserved. 2012;23(2):666–77.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ridker PM, MacFadyen JG, Nordestgaard BG, Koenig W, Kastelein JJ, Genest J, et al. Rosuvastatin for primary prevention among individuals with elevated high-sensitivity c-reactive protein and 5% to 10% and 10% to 20% 10-year risk. Implications of the Justification for Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial for “intermediate risk”. Circ Cardiovasc Qual Outcomes. 2010;3(5):447–52.

  39. Chambers JC, Eda S, Bassett P, Karim Y, Thompson SG, Gallimore J, R et al. C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites. Circulation. 2001;104(2):145–50.

  40. Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107(3):363–9.

    Article  PubMed  Google Scholar 

  41. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013;382(9907):1762–5.

    Article  PubMed  Google Scholar 

  42. McNeely M, Boyko E. Type 2 diabetes prevalence in Asian Americans: results of a national health survey. Diabetes Care. 2004;27(1):66–9.

    Article  PubMed  Google Scholar 

  43. Kuczmarski R, Carrol M, Flegal K, Troian R. Varying body mass index cut-off points among US adults: NHANES II (1988–1994). Obes Res. 1997;5(6):542–8.

    Article  CAS  PubMed  Google Scholar 

  44. Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation. 2007;115(7):928–35.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are most grateful for all our participants and research study volunteers without whom this study would not have been made possible. This work was supported in part by the University of North Florida Dean’s Professorship Grant.

Author information

Authors and Affiliations

  1. University of Florida, Jacksonville, FL, USA

    Irma B. Ancheta

  2. University of North Florida, Jacksonville, FL, USA

    Cynthia A. Battie

  3. Rush University Medical Center, Chicago, IL, USA

    Annabelle S. Volgman

  4. University of South Florida, Tampa, FL, USA

    Christine V. Ancheta

  5. Stanford University, Stanford, CA, USA

    Latha Palaniappan

Authors
  1. Irma B. Ancheta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cynthia A. Battie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annabelle S. Volgman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christine V. Ancheta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Latha Palaniappan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Irma B. Ancheta.

Ethics declarations

Funding

This study was funded by the University of North Florida Dean’s Professorship Grant (#10-1025).

Conflict of Interest

Corresponding author, Irma B. Ancheta, PhD, RN, and all contributing authors declare that I/us have no conflict of interest.

Ethical Approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. Not applicable.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ancheta, I.B., Battie, C.A., Volgman, A.S. et al. Cardiovascular Disease Risk Score: Results from the Filipino–American Women Cardiovascular Study. J. Racial and Ethnic Health Disparities 4, 25–34 (2017). https://doi.org/10.1007/s40615-015-0196-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40615-015-0196-6

Keywords

Search

Navigation