Revista Española de Salud Pública
Print version ISSN 1135-5727
CUENDE, Jose I et al. Cardiovascular Risk Percentiles Avoid Overestimation or Underestimation of Risk Calculated by the SCORE Risk Function. Rev. Esp. Salud Publica [online]. 2006, vol.80, n.2, pp. 125-138. ISSN 1135-5727. http://dx.doi.org/10.1590/S1135-57272006000200003.
Background: Cardiovascular risk evaluation is of the utmost importance for treatment of patients with cardiovascular risk factors. There are various scales or equations and they can be adapted to a particular population to try to avoid over or under estimation of risk. We propose risk percentiles as a new method of adapting risk scoring systems to our population. Methods: A cross sectional study of the prevalence of cardiovascular risk factors in the province of Palencia (ERVPA: Cardiovascular Risk Study in Palencia) was conducted. Age, gender, blood pressure, total cholesterol, tobacco consumption and diabetes were evaluated. 514 subjects aged 20 - 79 taken from the general population were studied in 9 health centers from Palencia (Spain). Fatal cardiovascular risk was measured with SCORE project equations. Percentiles were calculated and compared to both equations and a Spearman´s correlation coefficient and a kappa agreement coefficient were calculated. Results: The percentages of high risk range from 0% in young subjects to 92% in males over the age of 70 and 67% in females over the age of 70. The concordance with high risk country equations has a kappa coefficient of 0.741. Concordance varies greatly with age and gender. On comparing the percentiles, the concordance between both equations is almost absolute. Conclusions: Adopting risk percentiles as a method of cardiovascular risk evaluation permits us to adapt any risk equation to a particular area and avoids underestimation or overestimation of risk. Risk percentiles allow us to extrapolate absolute risk for any age.
Keywords : Cardiovascular Diseases; Epidemiology; Cross-Sectional Studies; Risk Assessment.