Abstract
Objective. This study aimed at investigating whether cardiovascular risk factors and their impact on total risk estimation differ between men and women. Design. Cross-sectional cohort study. Subjects. Finnish cardiovascular risk subjects (n = 904) without established cardiovascular disease, renal disease, or known diabetes. Main outcome measures. Ankle-brachial index (ABI), estimated glomerular filtration rate (eGFR), oral glucose tolerance test, and total cardiovascular risk using SCORE risk charts. Results. According to the SCORE risk charts, 27.0% (95% CI 23.1–31.2) of the women and 63.1% (95% CI 58.3–67.7) of the men (p < 0.001) were classified as high-risk subjects. Of the women classified as low-risk subjects according to SCORE, 25% had either subclinical peripheral arterial disease or renal insufficiency. Conclusions. The SCORE system does not take into account cardiovascular risk factors typical in women, and thus underestimates their total cardiovascular risk. Measurement of ABI and eGFR in primary care might improve cardiovascular risk assessment. especially in women.
Highlights
Cardiovascular disease (CVD) is the main cause of death in Europe and accounts for 54% of deaths in women and 43% of deaths in men [1]
When the risks of women and men were extrapolated to 70 years using SCORE risk charts, 412/481 (85.7% [95% CI 82.2–88.7]) and 423/423 (100.0% [95% CI 99.1–100)] had SCORE Ն 5%, respectively
Our results from a cohort of 904 cardiovascular risk subjects show that the SCORE system does not take into account typical cardiovascular risk factors in women
Summary
Cardiovascular disease (CVD) is the main cause of death in Europe and accounts for 54% of deaths in women and 43% of deaths in men [1]. The key question to be resolved is how to best define high risk; to use total CVD risk-estimating tools like SCORE, to assess additional risk factors like renal function and glucose homeostasis, or to use indicators of asymptomatic atherosclerosis like measurement of ankle-brachial index (ABI). We applied these methods, which are available to a general practitioner (GP), to compare CVD risk estimation between male and female subjects. Our study subjects were selected from the general population by using a two-stage screening method, in order to create a cohort of subjects who form a typical dilemma (Received 16 March 2011; accepted 11 February 2012)
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