title: Application of two versions of the WHO/international society of hypertension absolute cardiovascular risk assessment tools in a rural Bangladeshi population.
abstract: OBJECTIVE
  To estimate the absolute cardiovascular disease (CVD) risk burden in a remote rural Bangladeshi population using the 'With' and 'Without' Cholesterol versions of the WHO/International Society of Hypertension (WHO/ISH) CVD risk assessment chart (particularly suitable for low and middle-income countries due to less reliance on laboratory testing) and to evaluate the agreement between the two approaches.
  
  
  METHODS
  Cross-sectional study using data from a large prospective cohort of the North Bengal Non-Communicable Disease Programme (NB-NCDP) of Bangladesh.
  
  
  METHODS
  General rural population from Thakurgaon district of Bangladesh.
  
  
  METHODS
  563 individuals who were categorised as having 'no CVDs' on screening by a questionnaire-based survey using the 'WHO CVD-Risk Management Package' developed in 2002.
  
  
  METHODS
  Absolute CVD risk burden assessed using two versions of the WHO/ISH risk assessment charts for the South-East Asian Region-D.
  
  
  RESULTS
  10-year risk (moderate, high and very high) positivity was present among 21.5% and 20.2% of participants, respectively, using with and without cholesterol versions of the tool. The overall concordance rate for the two versions was 89.5% and they did not differ significantly in estimating the proportion of overall participants having higher levels of CVD. The projected drug requirement, however, showed a significant overestimation in the proportion of participants at both the threshold levels (p<0.002) on using 'without' as compared to 'with' cholesterol versions.
  
  
  CONCLUSIONS
  About one-fifth of the adult population in Bangladesh, even in a remote rural area, seem to be at risk of developing CVDs (25% of them at high risk and 25% at very high risk) within 10 years with males and females being almost equally vulnerable.
authors.affiliation: Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh Faculty of Medicine, The School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Kaniz
authors.initials: K
authors.lastname: Fatema
authors.affiliation: Faculty of Medicine, The School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Nicholas Arnold
authors.initials: NA
authors.lastname: Zwar
authors.affiliation: Faculty of Health and Medicine, Centre for Clinical Epidemiology and Biostatistics (CCEB), The School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Abul Hasnat
authors.initials: AH
authors.lastname: Milton
authors.affiliation: Faculty of Medicine, The School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Bayzidur
authors.initials: B
authors.lastname: Rahman
authors.affiliation: Department of Biochemistry and Cell Biology, BUHS, Dhaka, Bangladesh.
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012424:Rural Population; D012955:Societies, Medical; D014944:World Health Organization
keywords: Bangladesh; Cardiovascular diseases; Cholesterol; risk assessment