Prevalence of Cardiovascular Disease Risk Factors And Assessment of 10-Year Risk of Developing Cardiovascular Diseases in Premenopausal and Postmenopausal Women with Type 2 Diabetes: A Comparative Analysis

Abstract

Objective: This study aimed to assess the prevalence of cardiovascular disease (CVD) risk factors and compare the performance of the World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction score and Framingham risk score (FRS) in predicting CVD risk among pre- and postmenopausal females. Materials and methods: This cross-sectional study was conducted on a total of 293 female subjects with type 2 diabetes at Colombo South Teaching Hospital, Sri Lanka. The 10-year risk of developing CVD was calculated using WHO/ISH charts and FRSs and compared. The tools were validated through the use of elevated LDL-C levels, high diastolic blood pressure, high HbA1c and elevated fasting plasma glucose levels. Results: Among the study population, 25.9%, 54.9%, 50.8%, 98.0% and 0% had dyslipidemia, hypertension, obesity/overweight, central obesity, and smoking, respectively. The CVD risk was significantly greater among postmenopausal women than premenopausal women (p < 0.05). The FRS identified 23.2%, 48.8%, 20.8% and 7.2% of women as low risk ( < 10%), moderate risk (10–19.9%), high risk (20–29.9%) and very high risk (≥ 30%), respectively, whereas the WHO/ISH identified 78.8%, 14.3%, 2.0% and 4.8%, respectively. There was a significant discrepancy in the agreement between the two tools (k value = 0.068, p < 0.05). WHO/ISH charts revealed that the majority of women with elevated LDL-C levels (80.2%) were low-risk individuals, while FRSs identified the majority of women with raised LDL-C levels (92.2%) as moderate/high risk. Conclusions: There was a significant discrepancy in the performance of the WHO/ISH and FRS. WHO/ISH underestimates CVD risk, while the FRS identifies high-risk women who require therapeutic interventions.