Health risks
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Cardiovascular health risks

Cardiovascular health risks

Shen.AI provides functionalities able to compute the following metrics related to cardiovascular system dysfunctions:

  • Risks of cardiovascular events (CV events)
  • Risks of cardiovascular diseases (CV diseases)
  • Vascular age
  • Risk factors scores

Risks of cardiovascular events

The estimated risk of a first hard atherosclerotic cardiovascular event in the next 10 years (coronary death, myocardial infarction, or stroke) for someone without CVD. The estimation is based on the race- and sex-specific Pooled Cohort Equations developed in 2013 by the Risk Assessment Work Group of the American College of Cardiology/American HeartAssociation using a combination of risk factors (age, high systolic blood pressure (treated or non-treated), dyslipedemia (total and high-density lipoprotein cholesterol), smoking, and diabetes) examined in several cohorts of patients in USA (Goff Jr et al. Circulation, 2014;129(25 Suppl 2):S49-73). For races other than caucasian white or African-American, the risk estimation is based on the model validated on caucasian white populations, and hence the actual risk may be different. In particular, compared to caucasian white population, the cardiovascular risk is generally higher for American-Indian populations, and lower for Hispanic/Latin and Asian populations.

The following risks are computed:

  • Hard CV events (coronary death, myocardial infarction, or stroke) - based on Pooled Cohort Equations (USA)
  • Fatal CV events (European SCORE):
    • Coronary death
    • Fatal stroke
    • Total cardiovascular mortality (coronary + stroke)

Data needed to compute CV events risks:

  • age
  • gender
  • being currently a smoker
  • fasting glucose > 125 mg/dL or use of insulin or hypoglycemic medications - diabetes (only for hard CV events)
  • treated hypertension (only for hard CV events)
  • systolic blood pressure
  • total cholesterol level
  • HDL level (only for hard CV events)
  • race (only for hard CV events)
  • country (only for fatal CV events)

Risks of cardiovascular diseases

The estimated risk of atherosclerotic cardiovascular disease in the next 10 years is based on multivariable sex-specific risk prediction algorithms derived from the famous Framingham Heart Study (Framingham risk functions), with the following risk factors included: age, high systolic blood pressure (treated or non-treated), dyslipedemia (total and high-density lipoprotein cholesterol) or high body mass index (BMI), smoking, and diabetes (D'Agostino et al., Circulation, 2008;117:743-753). The Framingham risk functions are based on data mainly from caucasian white population, and hence for different races the actual risk may be different. In particular, compared to caucasian white population, the cardiovascular risk is generally higher for African-American and American-Indian populations, and lower for Hispanic/Latin and Asian populations.

The following risks are computed:

  • Atherosclerotic cardiovascular disease (CVD) - overall risk
  • Specific CVD risks:
    • Coronary heart disease risk (myocardial infarction, coronary death, coronary insuffciency, angina)
    • Stroke risk (ischemic stroke, hemorrhagic stroke, transient ischemic attack)
    • Heart failure risk
    • Peripheral vascular disease risk (intermittent claudication)

Data needed to compute CVD risks:

  • age
  • gender
  • being currently a smoker
  • fasting glucose > 125 mg/dL or use of insulin or hypoglycemic medications - diabetes
  • treated hypertension
  • systolic blood pressure
  • total cholesterol level and HDL level or body height and weight

Depending on which data from the last point is provided, risks are computed based on cholesterol level (more accurate) or body mass index (less accurate).

Vascular age

Vascular age is calculated as the age of a person with the same predicted overall risk for developing atherosclerotic cardiovascular disease (CVD) but with all risk factors at a normal level (total cholesterol 180 mg/dL, HDL 45 mg/dL, non-treated systolic blood pressure 125 mm Hg, no diabetes, no smoking).

Data needed to compute vascular age:

  • age
  • gender
  • being currently a smoker
  • fasting glucose > 125 mg/dL or use of insulin or hypoglycemic medications - diabetes
  • treated hypertension
  • systolic blood pressure
  • total cholesterol level and HDL level or body height and weight

Depending on which data from the last point is provided, risks are computed based on cholesterol level (more accurate) or body mass index (less accurate).

Risks factors scores

In addition to risks Shen.AI can provide information how much each factor contributes to the overall risk of developing CVD in a scoring manner.

Scores computed for factors:

  • age
  • being currently a smoker
  • diabetes
  • systolic blood pressure
  • total cholesterol level and HDL level or BMI
  • total risk score