Risk of Atherosclerotic Cardiovascular Diseases in various Ethnicities of Pakistan

OBJECTIVE: To estimate the risk of atherosclerotic cardiovascular diseases (ASCVD) in various ethnicities of Pakistan using Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) risk calculator and the Pooled Cohort Equations (PCE). METHODS: Individuals of both gender between 40 to 65 years of age without pre-existing coronary artery disease from residents of Karachi were recruited through snowball sampling technique. Study was conducted at the National Institute of Cardiovascular Diseases, Karachi, Pakistan during January to June 2019. Ethnicity of the participants was categorized based on their mother tongue. Ten-year risk of ASCVD event was estimated using Astro-CHARM Calculator and PCE. RESULTS: Mean age of a total of 386 individuals was 49(±7.1) years and 45.3% (175) were females. Urdu-speaking individuals were 33.4%(129) of the sample, while, 18.4%(71) Pushtoons, 14%(54) Sindhi, 13%(50) Punjabi, 2.6%(10) Balochi, and remaining 18.7%(72) were of other ethnicities. High risk (≥7.5%) individuals were 20.7% (80/386) as per PCE and 11.1% (43/386) as per Astro-CHARM. As per Astro-CHARM, Sindhis’ had the least risk of ten-years ASCVD event among all the ethnicities, while, Urdu-speakings’ had the highest risk with mean rank of 145.18 vs. 216.50, p-value=0.001. CONCLUSION: A significant 10-years risk of first ASCVD event was observed in our population. ASCVD risk is alarmingly high in some ethnicities, such as Urdu-speaking, owing to the increased prevalence of traditional modifiable risk factors, such as diabetes and smoking.