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Background <p>Risk assessment tools have been developed globally to aid in managing cardiovascular diseases (CVDs). This study assessed population-specific risk tools on cardiovascular patients in Trinidad and Tobago (T&amp;T), with focus on age, sex and geographic location.</p> Methods <p>Data from medical records of CVD patients admitted to a private hospital in T&amp;T between 2015 and 2021 were applied to three tools intended for use in T&amp;T—WHO risk chart, HEARTS in the Americas, and Globorisk. These tools assigned a risk category using predictors, such as age, sex, diabetes, systolic blood pressure, smoking, total cholesterol and body mass index. The categories were used to calculate the sensitivity of each tool; after stratifying based on age group, sex and area-type, chi-square tests of independence were conducted.</p> Results <p>The sample comprised 151 CVD patients (mean age: 58.8 ± 10.8 years, 76% males) from each administrative region in T&amp;T. Overall, HEARTS had the highest sensitivity of 80% (WHO: 44%, Globorisk: 20%). When stratified by age, risk was significantly underestimated more for patients &lt; 60 years by all tools (WHO: <i>p</i> &lt; 0.001, HEARTS: <i>p</i> = 0.002, Globorisk: <i>p</i> = 0.001). For sex, HEARTS misclassified females more than males (45% vs. 13%, <i>p</i> = 0.001); non-significant sex differences were observed with the other tools (WHO: <i>p</i> = 0.190, Globorisk: <i>p</i> = 0.863). No significant differences were found for area type (WHO: <i>p</i> = 0.519, HEARTS: <i>p</i> = 0.156, Globorisk: <i>p</i> = 0.796).</p> Conclusions <p>HEARTS had the best performance, though demographic differences were noted. It is recommended that future studies apply these tools to local prospective data from the general population to illuminate the status of CVD at the national level.</p>

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Demographic and geographic disparities of population-specific risk assessment tools on cardiovascular patients in Trinidad and Tobago

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Sasha Ramkhelawan,
  • Andrea Joseph,
  • Ricardo Clarke,
  • Ronald Henry

摘要

Background

Risk assessment tools have been developed globally to aid in managing cardiovascular diseases (CVDs). This study assessed population-specific risk tools on cardiovascular patients in Trinidad and Tobago (T&T), with focus on age, sex and geographic location.

Methods

Data from medical records of CVD patients admitted to a private hospital in T&T between 2015 and 2021 were applied to three tools intended for use in T&T—WHO risk chart, HEARTS in the Americas, and Globorisk. These tools assigned a risk category using predictors, such as age, sex, diabetes, systolic blood pressure, smoking, total cholesterol and body mass index. The categories were used to calculate the sensitivity of each tool; after stratifying based on age group, sex and area-type, chi-square tests of independence were conducted.

Results

The sample comprised 151 CVD patients (mean age: 58.8 ± 10.8 years, 76% males) from each administrative region in T&T. Overall, HEARTS had the highest sensitivity of 80% (WHO: 44%, Globorisk: 20%). When stratified by age, risk was significantly underestimated more for patients < 60 years by all tools (WHO: p < 0.001, HEARTS: p = 0.002, Globorisk: p = 0.001). For sex, HEARTS misclassified females more than males (45% vs. 13%, p = 0.001); non-significant sex differences were observed with the other tools (WHO: p = 0.190, Globorisk: p = 0.863). No significant differences were found for area type (WHO: p = 0.519, HEARTS: p = 0.156, Globorisk: p = 0.796).

Conclusions

HEARTS had the best performance, though demographic differences were noted. It is recommended that future studies apply these tools to local prospective data from the general population to illuminate the status of CVD at the national level.