This article describes the development of an assessment tool to predict global vascular risk in multiethnic individuals by including behavioral and anthropometric factors. They developed this prediction tool with the NOMAS (Northern Manhattan Study) cohort which is a prospective, population-based cohort of 2,737 community participants free of stroke and coronary artery disease with a follow-up period of approximately 9 years. The results showed a better prediction of global vascular risk (stroke, myocardial infarction, vascular death) by adding behavioral risk factors (alcohol consumption and physical activity) as well as waist circumference to the traditional cardiovascular profile. The authors highlighted the fact that waist circumference was a better predictor of risk than the body mass index and that the use of continuous variables rather than categorical classifications (fasting blood sugar instead of diabetes, blood pressure instead of hypertension) allowed a more precise risk assessment. The NOMAs score was developed from a multiethnic cohort including African-American and Hispanic individuals. The authors suggest that this global vascular risk score could improve primary prevention strategies for cardiovascular disease and stroke.
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