COMORBIDITY BURDEN AND CARDIOVASCULAR RISK STRATIFICATION USING SCORE2 AND SCORE2-OP IN RURAL PRIMARY CARE SETTINGS

Abstract

Background: Cardiovascular disease is a leading cause of morbidity and mortality in Vietnam. A growing prevalence of comorbid illnesses further exacerbates this burden. Although risk stratification tools like SCORE2 and SCORE2-OP support early intervention, their use in primary care remains limited. This study assessed 10-year cardiovascular risk and its association with comorbidity and other factors in a rural Vietnamese hypertensive population. Methods: A cross-sectional study was conducted between January and September 2024 among 367 hypertensive patients aged 40 - 79 attending rural primary care facilities in Kon Tum province. SCORE2 and SCORE2-OP were used to estimate 10-year CVD risk. The Charlson Comorbidity Index (CCI) was utilized to evaluate the comorbidity burden. Sociodemographic data, clinical indicators, and self-care behaviours were collected. A multivariate logistic regression analysis was performed to identify factors linked to elevated or very high cardiovascular risk. Results: 64.0% of participants were classified as having high or very high cardiovascular risk. High-risk profiles were more common among older adults, males, those with central obesity, and individuals with poor weight management. In multivariate analysis, higher CCI scores were independently associated with increased cardiovascular risk (OR = 1.28, 95%CI: 1.01-1.62, p<0.05). Central obesity and elevated total cholesterol showed significant positive associations with higher risk, whereas higher levels of LDL-C and HDL-C were inversely associated (p<0.05). Conclusion: A substantial proportion of rural hypertensive adults were at high cardiovascular risk, underscoring robust primary care screening and prevention. Integrating comorbidity assessment and behavioural risk factors into routine CVD risk stratification, potentially through electronic health records, may enhance early identification and targeted interventions in low-resource settings.