Unique score provides objective assessment of cardiovascular disease risk

המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-13 18:05:36 EDT (Reuters Health)

By Karla Gale

LONDON (Reuters Health) – European researchers have devised a scoring system that enhances physicians' and patients' ability to determine management strategies for stroke and coronary heart disease.

Dr. Francois Gueyffier, of the Service de Pharmacologie Clinique, in Lyon, France, and associates used data from the antihypertensive intervention trials database, which includes eight major randomised controlled trials of antihypertensive drugs, to establish a risk score for death from cardiovascular disease. Included in their analysis were 47,000 participants, of whom 1639 died of cardiovascular cases during a mean of 5.2 years of follow-up.

Of 16 baseline factors available in all trials, 11 were significant predictors of risk. These included age, gender, systolic blood pressure, serum total cholesterol, height, serum creatinine concentration, smoking, diabetes, left ventricular hypertrophy, history of stroke and history of MI, they report in the July 14 issue of the British Medical Journal.

To calculate the risk score, points are added for each factor according to its association with risk. Assessment is specific for age and gender.

"Each of the risk factors included in the score should be routinely available to the clinician," Dr. Gueyffier told Reuters Health. "The risk score enables the clinician to consider the range of risk factors simultaneously rather than looking at each of them separately."

The investigators note that the analysis was weighted in favor of two UK trials. However, they believe that the score is readily applicable to the US, because the two countries have similar death rates for cardiovascular disease. The risks would be lower than calculated for individuals in France because cardiovascular death rates are much lower there, they add.

When asked about comparing his group's scoring method with other methods commonly used, Dr. Gueyffier said, "Despite its being quantitative and including many risk factors, the risk score can still be used as a simple addition of integer scores, and so does not necessarily require a calculator or computer program to use."

In addition, he added that the ability to represent risk numerically and graphically can help patients "quickly and maybe more concretely realize what is behind risk factors, putting them in perspective, for example, with the effect of age or gender."

The authors have established a Web site, www.riskscore.org.uk, for clinicians who will routinely use their scoring method.

BMJ 2001;323:75-81.

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