Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region.
<h4>Background</h4>The World Health Organization (WHO) non-laboratory cardiovascular disease (CVD) risk chart is sub-region-specific and is advocated in resource-constrained settings. However, the extent of agreement with laboratory-based assessment among hypertensive adults attending pr...
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Public Library of Science (PLoS)
2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0317640 |
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| author | Kojo Awotwi Hutton-Mensah Olayinka Rasheed Ibrahim Adaku Nwankwo George Bediako Nketiah Funmi Temidayo Adeniyi Abukari Yakubu Natogmah James Ayodele Ogunmodede Dike Ojji Olumide Adesola Biodun Sulyman Alabi Olugbenga Ayodeji Mokuolu Daniel Sarpong |
| author_facet | Kojo Awotwi Hutton-Mensah Olayinka Rasheed Ibrahim Adaku Nwankwo George Bediako Nketiah Funmi Temidayo Adeniyi Abukari Yakubu Natogmah James Ayodele Ogunmodede Dike Ojji Olumide Adesola Biodun Sulyman Alabi Olugbenga Ayodeji Mokuolu Daniel Sarpong |
| author_sort | Kojo Awotwi Hutton-Mensah |
| collection | DOAJ |
| description | <h4>Background</h4>The World Health Organization (WHO) non-laboratory cardiovascular disease (CVD) risk chart is sub-region-specific and is advocated in resource-constrained settings. However, the extent of agreement with laboratory-based assessment among hypertensive adults attending primary health centers (PHCs) in the West Africa sub-region remains unknown. This study compared 10-year CVD risk among adults with hypertension attending PHCs in Ghana and Nigeria.<h4>Materials and methods</h4>This cross-sectional study recruited 319 adults with hypertension at PHCs in Ghana and Nigeria. All participants had their blood pressure, anthropometrics, fasting blood sugar, and fasting cholesterol measured following standard procedures. WHO laboratory and non-laboratory CVD risks were assessed and compared using Kappa statistics, correlation, and Bland-Altman Plot.<h4>Results</h4>The median (interquartile range) for laboratory-based and non-laboratory-based CVD risk scores were comparable [7.0 (4.0 11.0) vs. 7.0 (4.0 to 11.0), p = 0.914]. Of the 319 participants, laboratory-based assessment classified 214 (67.1%) as low risk, while 210 (65.8%) were classified as low risk using the non-laboratory method. Eleven (3.4%) and 14 (4.4%) participants were classified as high-risk using laboratory- and non-laboratory-based methods, respectively. Overall, there was a very good positive correlation between the CVD risk assessment methods (r = 0.948, p<0.001). For all participants combined, there was substantial agreement (Kappa statistics), with K = 0.766. Bland-Altman showed a mean bias of 0.15 (SD = 1.74) in favor of non-laboratory-based assessment of CVD with an upper limit of 3.57 and a lower limit of -3.26.<h4>Conclusion</h4>There was substantial agreement between laboratory- and non-laboratory-based WHO CVD risk charts in this study. In low-resource settings, such as Ghana and Nigeria, the WHO non-laboratory CVD risk prediction model offers a huge opportunity for primary CVD prevention in adults with hypertension. |
| format | Article |
| id | doaj-art-659bcb5ecde64abdbfc6769b3e860430 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-659bcb5ecde64abdbfc6769b3e8604302025-08-20T03:46:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01206e031764010.1371/journal.pone.0317640Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region.Kojo Awotwi Hutton-MensahOlayinka Rasheed IbrahimAdaku NwankwoGeorge Bediako NketiahFunmi Temidayo AdeniyiAbukari Yakubu NatogmahJames Ayodele OgunmodedeDike OjjiOlumide AdesolaBiodun Sulyman AlabiOlugbenga Ayodeji MokuoluDaniel Sarpong<h4>Background</h4>The World Health Organization (WHO) non-laboratory cardiovascular disease (CVD) risk chart is sub-region-specific and is advocated in resource-constrained settings. However, the extent of agreement with laboratory-based assessment among hypertensive adults attending primary health centers (PHCs) in the West Africa sub-region remains unknown. This study compared 10-year CVD risk among adults with hypertension attending PHCs in Ghana and Nigeria.<h4>Materials and methods</h4>This cross-sectional study recruited 319 adults with hypertension at PHCs in Ghana and Nigeria. All participants had their blood pressure, anthropometrics, fasting blood sugar, and fasting cholesterol measured following standard procedures. WHO laboratory and non-laboratory CVD risks were assessed and compared using Kappa statistics, correlation, and Bland-Altman Plot.<h4>Results</h4>The median (interquartile range) for laboratory-based and non-laboratory-based CVD risk scores were comparable [7.0 (4.0 11.0) vs. 7.0 (4.0 to 11.0), p = 0.914]. Of the 319 participants, laboratory-based assessment classified 214 (67.1%) as low risk, while 210 (65.8%) were classified as low risk using the non-laboratory method. Eleven (3.4%) and 14 (4.4%) participants were classified as high-risk using laboratory- and non-laboratory-based methods, respectively. Overall, there was a very good positive correlation between the CVD risk assessment methods (r = 0.948, p<0.001). For all participants combined, there was substantial agreement (Kappa statistics), with K = 0.766. Bland-Altman showed a mean bias of 0.15 (SD = 1.74) in favor of non-laboratory-based assessment of CVD with an upper limit of 3.57 and a lower limit of -3.26.<h4>Conclusion</h4>There was substantial agreement between laboratory- and non-laboratory-based WHO CVD risk charts in this study. In low-resource settings, such as Ghana and Nigeria, the WHO non-laboratory CVD risk prediction model offers a huge opportunity for primary CVD prevention in adults with hypertension.https://doi.org/10.1371/journal.pone.0317640 |
| spellingShingle | Kojo Awotwi Hutton-Mensah Olayinka Rasheed Ibrahim Adaku Nwankwo George Bediako Nketiah Funmi Temidayo Adeniyi Abukari Yakubu Natogmah James Ayodele Ogunmodede Dike Ojji Olumide Adesola Biodun Sulyman Alabi Olugbenga Ayodeji Mokuolu Daniel Sarpong Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region. PLoS ONE |
| title | Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region. |
| title_full | Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region. |
| title_fullStr | Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region. |
| title_full_unstemmed | Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region. |
| title_short | Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region. |
| title_sort | comparison of who laboratory based and non laboratory based cvd risk charts among hypertensive adults attending primary healthcare centers in west africa sub region |
| url | https://doi.org/10.1371/journal.pone.0317640 |
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