DIFFERENCES BETWEEN SCORE, FRAMINGHAM RISK SCORE AND ESTIMATED PULSE WAVE VELOCITY-BASED VASCULAR AGE CALCULATION METHODS - DATA FROM THREE GENERATIONS HEALTH PROGRAM IN HUNGARY

Abstract

Objective: Early vascular ageing contributes to cardiovascular (CV) morbidity and mortality. There are different possibilities to calculate vascular age including methods based on CV risk scores, but different methods might identify different subjects with early vascular ageing. We aimed to compare SCORE and Framingham Risk Score (FRS)-based vascular age calculation methods on subjects that were involved into a national screening program in Hungary. We also aimed to compare the distribution of subjects identified with early vascular ageing based on estimated pulse wave velocity (ePWV). Design and method: The Three Generations for Health program focuses on the development of primary health care in Hungary. One of the key elements of the program is the identification of risk factors of CV diseases. Vascular ages based on SCORE and FRS were calculated based on previous publications and were compared with chronological age and with each other in the total population and in patients with hypertension or diabetes. ePWV was calculated based on a method published previously. Supernormal, normal, and early vascular ageing were defined as <10%, 10-90% and >90% ePWV values of the participants. Results: 99 231 subjects were involved in the study and among them 49 191 patients had hypertension (HT) and 15 921 patients had diabetes (DM). Chronological age of the total population was 54.0 (48.0 – 60-0) years, while SCORE and FRS vascular ages were 59.0 (51.0 – 66.0) and 64.0 (51-80) years, respectively. In HT patients chronological, SCORE and FRS vascular ages were 57.0 (51.0 – 62.0), 63.0 (56.0 – 68.0) and 79.0 (64.0 – 80.0) years, respectively. In DM patients chronological, SCORE and FRS vascular ages were 58.0 (52.0 – 62.0), 63.0 (56.0 – 68.0) and 80.0 (76.0 – 80.0) years, respectively. Based on ePWV, FRS identified patients with elevated vascular age with high sensitivity (97.3%), while in case of SCORE, the sensitivity was much lower (13.3%). Conclusions: In conclusion, different vascular age calculation methods can provide different vascular age results in a population-based cohort. The importance of this finding for the implementation into CV preventive strategies requires further studies.