SY 04-3 SCREENING FOR NON-COMMUNICABLE DISEASES USING A SIMPLE, NON-INVASIVE RISK ASSESSMENT INSTRUMENT IN DEVELOPING COUNTRIES.

Cardiovascular risk prediction has developed significantly during recent years, as cardiovascular disease prevention guidelines recommend risk scores to identify patients at high and low risk. Where novel biomarkers were identified in recent years, it is simply impractical and expensive to perform laboratory testing as part of screening for non-communicable diseases in low- and middle-income countries. As part of a broader consortium we compared the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. The non-laboratory based score included: age, systolic blood pressure, smoking status, body mass index, reported diabetes status, and current treatment for hypertension. In an additional longitudinal study we also compared different non-invasive estimates of obesity and found that waist-to-height ratio may be a more effective tool to measure obesity and predict cardiometabolic risk than the generally known measurements such as body mass index and waist circumference.We found that a non-laboratory-based CVD risk assessment tool ranked individuals nearly identically compared to risk scores that require additional expensive cholesterol tests. By using the non-laboratory-based risk assessment tool, we estimate that nearly 20% of the South African adult population is at high CVD risk. Health care providers that have limited resources and time in overcrowded primary health clinics can therefore assess risk and make decisions on therapy in a much cheaper manner using results similar to those obtained using blood-based risk tools.