Carlos Brotons1, Irene Moral2, Diana Fernández2, Lluis Cuixart3, Alex Muñoz3, Anna Soteras2, Mireia Puig2, Xavier Joaniquet3, Albert Casasa2. 1. Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, España; Unidad Docente ACEBA, Barcelona, España. Electronic address: cbrotons@eapsardenya.cat. 2. Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, España; Unidad Docente ACEBA, Barcelona, España. 3. Unidad Docente ACEBA, Barcelona, España; Equip d'Atenció Primària Dreta de l'Eixample, Barcelona, España.
Abstract
BACKGROUND AND OBJECTIVE: Estimating cardiovascular risk with SCORE is not recommended in persons over 65 years. SCORE investigators have recently published specific tables for older people (SCORE Older Persons [SCORE OP]). The aim of this study is to assess the impact of using SCORE OP tables on a Spanish population aged over 64 years, and compare it with the use of SCORE in patients aged 65-69 years. PATIENTS AND METHOD: Cross-sectional study carried out in 2 urban primary health care centres. Individuals between 65 and 85 years old without diabetes or established cardiovascular diseases were included. Cardiovascular risk using SCORE and the new SCORE OP tables for low risk countries was calculated. RESULTS: Cardiovascular risk was estimated in 3,425 patients. Mean values of the original SCORE and SCORE OP were 4.08 and 3.83, respectively in the group of patients aged 65-69 years old (n=974, 22.44%) (P< .001). The percentage of patients at high or very high risk was 25.46% and 22.90% with the original SCORE and the SCORE OP, respectively (P<.001). Using the original SCORE, 16.43% of the total patients should potentially be treated with lipid lowering drugs, while using the SCORE OP, 13.45% of the patients aged 65-69 years should potentially be treated. Using SCORE OP in patients older than 69 years, 61.49% patients should potentially be treated with lipid lowering drugs. CONCLUSIONS: SCORE OP identifies fewer patients at high or very high risk than the original SCORE, therefore, its utilization would imply treating fewer patients of this age with lipid lowering drugs.
BACKGROUND AND OBJECTIVE: Estimating cardiovascular risk with SCORE is not recommended in persons over 65 years. SCORE investigators have recently published specific tables for older people (SCORE Older Persons [SCORE OP]). The aim of this study is to assess the impact of using SCORE OP tables on a Spanish population aged over 64 years, and compare it with the use of SCORE in patients aged 65-69 years. PATIENTS AND METHOD: Cross-sectional study carried out in 2 urban primary health care centres. Individuals between 65 and 85 years old without diabetes or established cardiovascular diseases were included. Cardiovascular risk using SCORE and the new SCORE OP tables for low risk countries was calculated. RESULTS: Cardiovascular risk was estimated in 3,425 patients. Mean values of the original SCORE and SCORE OP were 4.08 and 3.83, respectively in the group of patients aged 65-69 years old (n=974, 22.44%) (P< .001). The percentage of patients at high or very high risk was 25.46% and 22.90% with the original SCORE and the SCORE OP, respectively (P<.001). Using the original SCORE, 16.43% of the total patients should potentially be treated with lipid lowering drugs, while using the SCORE OP, 13.45% of the patients aged 65-69 years should potentially be treated. Using SCORE OP in patients older than 69 years, 61.49% patients should potentially be treated with lipid lowering drugs. CONCLUSIONS: SCORE OP identifies fewer patients at high or very high risk than the original SCORE, therefore, its utilization would imply treating fewer patients of this age with lipid lowering drugs.