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Gomez-Sanchez L, Gomez-Marcos MA, Patino-Alonso MC, Recio-Rodriguez JI, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez JA, Ramos R, Garcia-Ortiz L, Rodriguez-Sanchez E. Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study. Med Clin (Barc) 2019; 153:351-356. [PMID: 30929863 DOI: 10.1016/j.medcli.2019.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE The estimation of cardiovascular risk (CVR) with scores at 30 years old has a special interest in reclassifying in a suitable way <60 year subjects with intermediate CVR. This study analyzes what percentage of patients with intermediate CVR included in the MARK study is reclassified by applying the 30-year Framingham score (FS30). It also analyzes the degree of agreement between the two equations to classify high risk subjects. PATIENTS AND METHODS Cross-sectional study of 966 subjects included in the MARK study. The CVR was calculated with the two versions of the FS30 (based on lipids and body mass index) for "hard" cardiovascular events in subjects with intermediate CVR. RESULTS The 59% and 61% of the subjects with intermediate CVR would be classified as if they had high CVR to undergo a hard event if we used the FS30 in both versions. 70% of men and 35% of women would be classified as high CVR (p<0.01). The agreement percentage, measured with the Kappa index, between the equations FS30L and FS30BMI to classify the high-risk subjects was 67.9% (in men 67.4% and in women 68.7%). CONCLUSIONS In subjects with intermediate CVR the FS30 reclassifies more than the half as high RCV, 2 out of 3 men and 1 out of 3 women.
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Affiliation(s)
- Leticia Gomez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Manuel A Gomez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Medicine, University of Salamanca, Salamanca, Spain.
| | - Maria C Patino-Alonso
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Health Service of Castilla y León (SACyL), Salamanca, Spain; Faculty of Health Sciences, University of Burgos, Spain
| | - Marta Gomez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain
| | - Jesús González-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Department of Nursing, University of Extremadura, Plasencia, Cáceres, Spain
| | - Rosario Alonso-Domínguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Rafel Ramos
- Girona Research Unit, Primary Care Research Institute Jordi Gol (IDIAP Jordi Gol), Biomedical Research Institute of Girona Dr. Josep Trueta (IDBGI), Girona, Spain; Department of Medical Sciences, University of Girona, Girona, Spain
| | - Luis Garcia-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Department of Biomedical Sciences and Diagnosis, University of Salamanca, Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Salamanca, Spain; Health Service of Castilla y León (SACyL), Salamanca, Spain; Department of Medicine, University of Salamanca, Salamanca, Spain
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- redIAPP: Research Network in Preventive Activities and Health Promotion, Spain
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Sisa I. Gender differences in cardiovascular risk assessment in elderly adults in Ecuador: evidence from a national survey. J Investig Med 2018; 67:736-742. [PMID: 30518558 DOI: 10.1136/jim-2018-000789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2018] [Indexed: 11/03/2022]
Abstract
The present study aimed to predict the risk of developing cardiovascular disease (CVD) over a 5-year period and how it might vary by sex in an ethnically diverse population of older adults. We used a novel CVD risk model built and validated in older adults named the Systematic Coronary Risk Evaluation in Older Persons (SCORE OP). A population-based study analyzed a total of 1307 older adults. Analyses were done by various risk categories and sex. Of the study population, 54% were female with a mean age of 75±7.1 years. According to the SCORE OP model, individuals were classified as having low (9.8%), moderate (48.1%), and high or very high risk (42.1%) of CVD-related mortality. Individuals at higher risk of CVD were more likely to be male compared with females, 53.9% vs 31.8%, respectively (p<0.01). Males were more likely to be younger, living in rural areas, had higher levels of schooling, and with the exception of smoking status and serum triglycerides, had lower values of traditional risk factors than females. In addition, males were less likely to require blood pressure-lowering therapy and statin drugs than females. This gender inequality could be driven by sociocultural determinants and a risk factor paradox in which lower levels of the cardiovascular risk factors are associated with an increase rather than a reduction in mortality. These data can be used to tailor primary prevention strategies such as lifestyle counseling and therapeutic measures in order to improve male elderly health, especially in low-resource settings.
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Affiliation(s)
- Ivan Sisa
- School of Medicine, College of Health Sciences, Universidad San Francisco de Quito, Quito, Ecuador
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