SAVE LIFE SAVE PAKISTAN THROUGH PRIMARY PREVENTION BY RISK STRATIFICATION OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE

About one fourth of the world population, living in South Asia region are at an increased risk atherosclerotic cardiovascular diseases (ASCVD).1,2 Pakistan’s population comprises over 200 million inhabitants Asian origin. According to a recent study, more than 30% Pakistani individuals were high (>7.5%) 10 years ASCVD event. Smoking, diabetes (type II), systemic hypertension, and cholesterol most prevalent modifiable factors.3 Ten assessment was done Karachi (a city representing whole Pakistan because multi ethnic composition) by offering pooled cohort equation Astronaut Cardiovascular Health Risk Modification (Astro-CHARM) calculators.3 stratification populations comparable with studies US.1 The study Ashraf et al.4 showed overall hypertension be 45.6%, mellitus 15.8%, current smoker 14.25%, family history myocardial infarction 30.57%. Regarding distribution ethnicities this Urdu speaking shown have increase trend for diabetes, smoking heart attack while Pushtoons (Table 1). coronary artery calcium (CAC) score various ethnicities, rate moderate (100 399 Agatstan Units) (≥ 400 Agatston among Punjabis 4% 8% respectively, while, it 7% 2.3% respectively.5 pairwise comparison ten disease (ASCVD) event Pooled Cohort Equation (PCE) Astro-CHARM Sindhi least risk.5 What needs done? Implementation through general practitioners. This can pharmaceutical friends involving all private public institutions countries. purpose achieved delivering lecturers demonstrations either direct or usual social media i.e. Zoom meetings, webinars, etc. An app created which installed GPs mobile phone. After stratification, life style modification, use statins will delivered public. All data assimilated analyzed share medical community further preventive strategies. A major setback calculator is that subjects under 40 age cannot calculated. having cardiac events mostly young group.6 To overcome plan baseline estimation using patients mentioned group. followed same mechanism follow up 5 years. Although scoring system including PCE may help primary prevention identifying risk. Through calculators need validation similar cohorts appropriate changes as needed.References: Volgman AS, Palaniappan LS, Aggarwal NT, Gupta M, Khandelwal A, Krishnan AV, al. Atherosclerotic Asians United States: epidemiology, factors, treatments: scientific statement from American Heart Association. Circulation. 2018;138(1):e1-34.George J, Mathur R, Shah AD, Pujades-Rodriguez Denaxas S, Smeeth L, Ethnicity first diagnosis wide range diseases: Associations linked electronic health record 1 patients. PloS One. 2017;12(6):e0178945.Hassan K, Mohydin B, Fawwad Waris N, Iqbal Jawaid M. Predicting population. Clin Epidemiol Glob Health. 2019;7(2):184-7.Ashraf T, Mengal MN, Muhammad Tareen AK, Khan Kazmi KA, south sub-population. BMC Public 2020;20(1):403.Ashraf Nadeem Sarwar Karim Diseases Ethnicities Pakistan. Journal Medical Sciences. 2020;36(6):1158.Batra MK, Rizvi NH, Sial JA, Saghir Angiographic characteristics hospital outcome patients, versus undergoing percutaneous intervention. J Pak Med Assoc. 2019;69(4):1307-11.