title: Distribution of Short-Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults.
abstract: BACKGROUND
  Short-term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time-point estimations; however, persons with low predicted short-term risk may have higher risks across longer time horizons.
  
  
  RESULTS
  We estimated short-term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short-term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short-term and low lifetime risk, low short-term and high lifetime risk, and high short-term predicted risk. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short-term estimated cardiovascular disease risk. Among those with a low short-term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short-term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (P<0.01). These results were consistent by sex.
  
  
  CONCLUSIONS
  These findings highlight potential shortcomings of using short-term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short-term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies.
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru (R.Q., J.C.B.A., M.S.B.P., J.A.P., A.B.O., J.M.).
authors.forename: Renato
authors.initials: R
authors.lastname: Quispe
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru (R.Q., J.C.B.A., M.S.B.P., J.A.P., A.B.O., J.M.).
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Bazo-Alvarez
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru (R.Q., J.C.B.A., M.S.B.P., J.A.P., A.B.O., J.M.) Duke University Research Institute, Duke University, Durham, NC (M.S.B.P.).
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Burroughs Peña
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru (R.Q., J.C.B.A., M.S.B.P., J.A.P., A.B.O., J.M.).
authors.forename: Julio A
authors.initials: JA
authors.lastname: Poterico
authors.affiliation: Asociación Benéfica PRISMA, Lima, Peru (R.H.G.) Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.H.G., W.C.).
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.H.G., W.C.) Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD (W.C.).
authors.forename: William
authors.initials: W
authors.lastname: Checkley
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru (R.Q., J.C.B.A., M.S.B.P., J.A.P., A.B.O., J.M.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Bernabé-Ortiz
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (M.D.H.).
authors.forename: Mark D
authors.initials: MD
authors.lastname: Huffman
authors.affiliation: CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru (R.Q., J.C.B.A., M.S.B.P., J.A.P., A.B.O., J.M.) Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru (J.M.).
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Miranda
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health; D012737:Sex Factors; D013997:Time Factors; D014504:Urban Health
keywords: Pooled Cohort Risk Equations; cardiovascular risk; lifetime cardiovascular risk; risk estimation tools; short‐term cardiovascular risk