Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2014;67:94-100 - Vol. 67 Num.02 DOI: 10.1016/j.rec.2013.06.018

Impact of Using Different SCORE Tables for Estimating Cardiovascular Risk

Carlos Brotons a,b,, Irene Moral a,b, Núria Soriano a,b,c, Lluís Cuixart b,d, Dimelza Osorio e, David Bottaro a,b, Mireia Puig a,b, Xavier Joaniquet b,d, Albert Marcos b,d, Albert Casasa a,b

a Unidad de Investigación, Equip d’Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
b Unidad Docente ACEBA, Barcelona, Spain
c Departamento de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública, Universitat Autònoma de Barcelona, Barcelona, Spain
d EAP Dreta de l’Eixample, Barcelona, Spain
e Servicio de Epidemiología Clínica y Salud Pública, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain

Refers to

Cardiovascular Risk Functions: Usefulness and Limitations
Roberto Elosua
Rev Esp Cardiol. 2014;67:77-9
Full text - PDF

Keywords

Cardiovascular risk. SCORE. Vascular age.

Abstract

Introduction and objectives

In Spain, various SCORE tables are available to estimate cardiovascular risk: tables for low-risk countries, tables calibrated for the Spanish population, and tables that include high-density lipoprotein values. The aim of this study is to assess the impact of using one or another SCORE table in clinical practice.

Methods

In a cross-sectional study carried out in two primary health care centers, individuals aged 40 to 65 years in whom blood pressure and total cholesterol levels were recorded between March 2010 and March 2012 were selected. Patients with diabetes or a history of cardiovascular disease were excluded. Cardiovascular risk was calculated using SCORE for low-risk countries, SCORE with high-density lipoprotein cholesterol, and the calibrated SCORE.

Results

Cardiovascular risk was estimated in 3716 patients. The percentage of patients at high or very high risk was 1.24% with SCORE with high-density lipoprotein cholesterol, 4.73% with the low-risk SCORE, and 15.44% with the calibrated SCORE (P<.01). Treatment with lipid-lowering drugs would be recommended in 10.23% of patients using the calibrated SCORE, 3.12% of patients using the low-risk SCORE, and 0.67% of patients using SCORE with high-density lipoprotein cholesterol.

Conclusions

The calibrated SCORE table classifies a larger number of patients at high or very high risk than the SCORE for low-risk countries or the SCORE with high-density lipoprotein cholesterol. Therefore, its use would imply treating more patients with lipid-lowering medication. Validation studies are needed to assess the most appropriate SCORE table for use in our setting.

1885-5857/© 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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