Mean Summary scores overall and by region and urban/rural.

<p>Figures in brackets are the range of each score determined from the distribution of mean scores for each summary score.</p><p>Mean Summary scores overall and by region and urban/rural.</p

Examples of high scoring communities.

<p>In these communities from urban Canada and rural Colombia the common high-scoring characteristics are complete sidewalks, several planted trees, traffic signals, and pedestrian traffic signs, well maintained buildings and roads and the presence of street furniture such as benches and street lamps.</p

Summary scores: Method to summarise scores based on combining constructs in similar domains.

<p>Summary scores: Method to summarise scores based on combining constructs in similar domains.</p

Communities studied.

<p>Communities studied.</p

Examples of low-scoring communities.

<p>These are pictures of 2 low scoring communities overall. You can see in communities from urban Canada and rural India there is partial or no sidewalks, not many crosswalks, not many planted trees or aesthetically pleasing features. In addition the buildings are not well maintained.</p

Features of communities and reliability of measures.

<p>Note: 1: Items with low reliability and 2: Items with moderate reliability. All other items had high reliability.</p><p>Features of communities and reliability of measures.</p

Biochemical tests and respective stability and methodology.

Biochemical tests and respective stability and methodology.</p

SPIRIT checklist.

Atherosclerotic Cardiovascular Disease (ASCVD) represents the leading cause of death worldwide, and individual screening should be based on behavioral, metabolic, and genetic profile derived from data collected in large population-based studies. Due to the polygenic nature of ASCVD, we aimed to assess the association of genomics with ASCVD risk and its impact on the occurrence of acute myocardial infarction, stroke, or peripheral artery thrombotic-ischemic events at population level. CardioVascular Genes (CV-GENES) is a nationwide, multicenter, 1:1 case-control study of 3,734 patients in Brazil. Inclusion criterion for cases is the first occurrence of one of the ASCVD events. Individuals without known ASCVD will be eligible as controls. A core lab will perform the genetic analyses through low-pass whole genome sequencing and whole exome sequencing. In order to estimate the independent association between genetic polymorphisms and ASCVD, a polygenic risk score (PRS) will be built through a hybrid approach including effect size of each Single Nucleotide Polymorphism (SNP), number of effect alleles observed, sample ploidy, total number of SNPs included in the PRS, and number of non-missing SNPs in the sample. In addition, the presence of pathogenic or likely pathogenic variants will be screened in 8 genes (ABCG5, ABCG8, APOB, APOE, LDLR, LDLRAP1, LIPA, PCSK9) associated with atherosclerosis. Multiple logistic regression will be applied to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI), and population attributable risks will be calculated.Clinical trial registration: This study is registered in clinicaltrials.gov (NCT05515653).</div

Eligibility criteria and genetic evaluation.

Atherosclerotic Cardiovascular Disease (ASCVD) represents the leading cause of death worldwide, and individual screening should be based on behavioral, metabolic, and genetic profile derived from data collected in large population-based studies. Due to the polygenic nature of ASCVD, we aimed to assess the association of genomics with ASCVD risk and its impact on the occurrence of acute myocardial infarction, stroke, or peripheral artery thrombotic-ischemic events at population level. CardioVascular Genes (CV-GENES) is a nationwide, multicenter, 1:1 case-control study of 3,734 patients in Brazil. Inclusion criterion for cases is the first occurrence of one of the ASCVD events. Individuals without known ASCVD will be eligible as controls. A core lab will perform the genetic analyses through low-pass whole genome sequencing and whole exome sequencing. In order to estimate the independent association between genetic polymorphisms and ASCVD, a polygenic risk score (PRS) will be built through a hybrid approach including effect size of each Single Nucleotide Polymorphism (SNP), number of effect alleles observed, sample ploidy, total number of SNPs included in the PRS, and number of non-missing SNPs in the sample. In addition, the presence of pathogenic or likely pathogenic variants will be screened in 8 genes (ABCG5, ABCG8, APOB, APOE, LDLR, LDLRAP1, LIPA, PCSK9) associated with atherosclerosis. Multiple logistic regression will be applied to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI), and population attributable risks will be calculated.Clinical trial registration: This study is registered in clinicaltrials.gov (NCT05515653).</div

SPIRIT study schedule for participant enrollment and assessments.

SPIRIT study schedule for participant enrollment and assessments.</p