Validation of Prediction of the Score (Systematic Coronary Risk Evaluation) in Urban Population

Abstract

P-778 Objectives: The premature death in highly developed countries is related mainly to cardiovascular atherosclerosis and malignant diseases, so the screening for subject in risk, primary prevention and early treatment should be a focus of the public health. Aim: The aim of the study was to assess validity of the SCORE risk estimation system in determining ten-year risk fatal cardiovascular disease (CVD) events in urban population. Material and Methods: The study was conducted in 2004–2005 as a part of the municipality sponsored program on Primary Prevention of the Atherosclerosis, Diabetes Type 2 and Hypertension. More than 40 000 subjects aged over 25 without any history of the CVD or diabetes type 2 participated in the study. The program was run in 42 general practitioners practices. In 13434 men and 27555 women anthropometric measurements, blood pressure, fasting total cholesterol and glycaemia tests were performed. Information about smoking status, family history of CVD and diabetes type 2 were collected by questionnaire. In subjects with elevated level of total cholesterol (> 5.2 mmol/l) HDL cholesterol and triglycerides tests were performed. Total cholesterol, systolic blood pressure and smoking status were used to assess 10-year risk of fatal cardiovascular disease event according to SCORE risk estimation system. Results: Among 40989 examined subjects 16,2% men and 40,9% women (p<0.05) were risk free. Risk below 5% was present in 53.1% of women and 51,.3% of men, risk between 6% and 14% in 30.4% men and 6% women. Very high risk (15% and over) was found in 8 women (0.03%) and 277 men (2.1%.). The applied logistic regression methods showed that the standard cardiovascular risk factors significantly underestimate the SCORE prediction: the highest risk factor was current smoking over 10 cigarettes daily (men: RR=12.4 95%CI: 10.3÷15.0 women: RR=9.1 95%CI: 7.5 11.÷1), obesity increased significantly the risk at 60% in men and 68% in women, glucose tolerance disturbances were also significant risk factors (diabetes mellitus: RR=1.57 for men and 1.43 for women, impaired glucose tolerance: RR=2.39 for both sexes) Conclusions: The SCORE outcome seems to be definite for health people exclusively while subjects with newly diagnosed diabetes mellitus, impaired glucose tolerance or obesity should be screened furthermore.