Filipino-American Women Cardiac Study: Comparison of Cardiovascular Risk Scores

Introduction: Filipino-American women (FAW) have multiple cardiovascular risk factors and high rates of cardiovascular disease (CVD). Currently, recognized and reputable CVD risk prediction models have been utilized in Caucasian populations and may not account for differences in prevalence of CVD risks especially among Filipino Americans. The purpose of the study was to compare the 10-year, 30-year Framingham Risk Score (FRS) and Reynold’s Risk Score (RRS) and the 10-year and lifetime atherosclerotic cardiovascular disease (ASCVD) scores to determine their ability to discriminate high and low CVD risk among FAW.

Methods: A cross-sectional study enrolled FAW (n=234), aged 40-65 without any acute or chronic inflammatory diseases. Prevalence of CVD risk score using the previously stated CVD risk scores were obtained and calculated.

Results: FAW have a high prevalence of CVD risk factors with 64% hypertensive, 61% with elevated LDL-C (>100 mg/dL), 48% positive CVD family history, and 56% had metabolic syndrome. The 10-year FRS and RRS showed that all participants were at low risk. The 30-year Lipid FRS reclassified subjects as 30% low risk, 38% intermediate risk and 32% at high risk. The 30-year BMI classified subjects as 22% low risk, 35% intermediate risk and 43% high risk over 30 years. The 10-year ASCVD showed 88% were at low risk, whereas the lifetime ASCVD classified 95% of participants as having high risk.  

Conclusion: The 10 year FRS and RRS underestimated CVD risk. The 10 year ASCVD and LRS overestimated of CVD risk. The 30- year FRS provided a discerning risk assessment. Findings from this study substantiates the argument that perhaps a more adaptable, feasible and applicable risk assessment tool tailored to the Filipino population is vitally needed to accurately discriminate and predict CVD risk because of the prevalence of CVD risk factors and disease processes unique to this population.