A Comparative Analysis of Cardiovascular Disease Risk Assessment Frameworks in India and Abroad: Focus on Framingham and Score Based Models

Abstract

SCORE and its updated version, SCORE 2, have been largely centered in Europe and focused on predictive schemes for fatal CVD events; they do not have any validation from Indian populations due to a shortage of longitudinal data (Kasim et al., 2023). The WHO/ISH charts, popular in resource-limited settings for their simplicity, underperform in identifying risks in young adults and women (Selvarajah et al., 2014). Depending mostly on conventional risk factors, these models don't include social determinants of health such as education, income, occupational stress, air pollution, and localized dietary habits, all of which shape India's CVD profile (Prabhakaran et al., 2016; Mathur et al., 2024). There is still insufficient representation of rural populations, and apart from that, these models suffer a practical dead-end: low clinical adoption, digital integration, as well as patient engagement have greatly hindered implementation.
While there remain prevention prospects under Ayushman Bharat and NPCDCS, a lack of a dynamic, India-specific CVD risk tool is certainly denying the country an effective population-level screening-means and intervention. While FRS and SCORE provide valuable foundations, their limitations in the Indian context necessitate development of inclusive, data-driven, and locally validated frameworks to better manage and reduce the country’s growing CVD burden.