A risk chart developed 15 years ago holds the key
With the World Health Organization (WHO) making high blood pressure this year's theme for World Health Day, the obvious question is: how does one tackle this silent killer? Experts suggest one way to deal with the problem could be to follow New Zealand’s heart foundation risk stratification grid.
This risk stratification provides a simple quantitative method for assessing a person's risk of cardiovascular disease. Doctors can use this to lower an individual's blood pressure or blood cholesterol with the use of drugs.
The grid includes different risk factors that lead to cardiovascular problems. Some of these are diabetic status, smoking history and age. Men and women have different risk factors. The chart helps the doctor figure out the cell nearest to the person’s age, systolic blood pressure, and the ratio of total cholesterol (TC) to HDL in the grid. The grid is given in eight colours that indicate the risk.
The chart is based on a Framingham heart study which is a long-term, ongoing cardiovascular study on residents of the town of Framingham, Massachusetts. Beginning in 1948 with 5,209 adult subjects from Framingham, the study is still continuing through the third generation.
President of the Public Health Foundation of India, K Srinath Reddy, said that the New Zealand heart foundation risk stratification grid was developed 15 years ago by Rodney Jackson, a professor. The model became the stimulus for other risk grids in Europe and other countries. This is the best available model of risk stratification and prediction based on multiple interactive risk factors. Reddy also happens to be president of World Heart Federation, a global non-profit.
The grid is most relevant to India as it takes into account HDL (high-density lipoprotein cholesterol, also called good cholesterol) along with total cholesterol while others rely only on total cholesterol. Indians have low HDL. Going by total cholesterol underestimates absolute cardiovascular risk in Indians, Reddy said.
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