Comparación de las tablas REGICOR y SCORE para la clasificación del riesgo cardiovascular y la identificación de pacientes candidatos a tratamiento hipolipemiante o antihipertensivo

Buitrago, Francisco; Cañón-Barroso, Lourdes; Díaz-Herrera, Natalio; Cruces-Muro, Eloísa; Escobar-Fernández, Miguel; Serrano-Arias, José M.

doi:10.1157/13099460

Cited by 44 publications

(15 citation statements)

References 27 publications

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“…The percentage of patients classified in this study as having a high CVR using the SCORE equation is similar to that reported by other studies in the primary care setting [19], in the general population [21], or in hypertensive individuals [30]. The D’Agostino scale classifies twice as many patients as being at high risk compared with the SCORE, and both scales classify a much larger proportion of males as presenting high risk.…”

Section: Discussionsupporting

confidence: 85%

“…However, of every 100 females with disagreement, approximately 53 showed high risk according to the D’Agostino scale and non-high risk according to the SCORE, while 47 showed non-high risk according to the D’Agostino scale and high risk as determined by the SCORE. These figures, while substantial, are lower than the disagreements reported in other studies [13,19,21]. …”

Section: Discussioncontrasting

confidence: 73%

“…The scales compared in this study measure CVR, mortality risk and morbidity-mortality risk. This is probably why agreement between the two scales shows a kappa index of 0.58, which is better than that published by other authors comparing the Framingham-REGICOR and SCORE [19,21,30], or the Framingham and SCORE [12,13,30], since these are equations that predict different cardiovascular events (coronary morbidity-mortality and cardiovascular mortality).…”

Section: Discussionmentioning

confidence: 70%

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Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

Gómez‐Marcos¹,

Grandes²,

Iglesias-Valiente³

et al. 2009

IJERPH

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Background:To evaluate agreement between cardiovascular risk in sedentary patients as estimated by the new Framingham-D’Agostino scale and by the SCORE chart, and to describe the patient characteristics associated with the observed disagreement between the scales.Design:A cross-sectional study was undertaken involving a systematic sample of 2,295 sedentary individuals between 40–65 years of age seen for any reason in 56 primary care offices. An estimation was made of the Pearson correlation coefficient and kappa statistic for the classification of high risk subjects (≥20% according to the Framingham-D’Agostino scale, and ≥5% according to SCORE). Polytomous logistic regression models were fitted to identify the variables associated with the discordance between the two scales.Results:The mean risk in males (35%) was 19.5% ± 13% with D’Agostino scale, and 3.2% ± 3.3% with SCORE. Among females, they were 8.1% ± 6.8% and 1.2% ± 2.2%, respectively. The correlation between the two scales was 0.874 in males (95% CI: 0.857–0.889) and 0.818 in females (95% CI: 0.800–0.834), while the kappa index was 0.50 in males (95% CI: 0.44%–0.56%) and 0.61 in females (95% CI: 0.52%–0.71%). The most frequent disagreement, characterized by high risk according to D’Agostino scale but not according to SCORE, was much more prevalent among males and proved more probable with increasing age and increased LDL-cholesterol, triglyceride and systolic blood pressure values, as well as among those who used antihypertensive drugs and smokers.Conclusions:The quantitative correlation between the two scales is very high. Patient categorization as corresponding to high risk generates disagreements, mainly among males, where agreement between the two classifications is only moderate.

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 70%

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Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

Gómez‐Marcos¹,

Grandes²,

Iglesias-Valiente³

et al. 2009

IJERPH

View full text Add to dashboard Cite

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“…It has been previously discussed that the former overestimates and the second underestimates CVR. 31 More recently, Gil-Guillé n et al 11 assessed the agreement of these two equations in the identification of high-risk individuals among more than 8000 people without established CVD, and found low concordance between them (k = 0.463), where SCORE classified as high risk nearly twice as many people as Framingham-REGICOR. In our study, however, the two strategies had substantial (almost perfect for females) agreement when diabetes (a priori high or very-high risk condition for SCORE) was excluded (Table 1), and when situations such as total cholesterol > 8 mmol/L, systolic blood pressure !…”

Section: Discussionmentioning

confidence: 99%

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Amor

Masana

Soriguer

et al. 2015

Revista Española de Cardiología (English Edition)

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“…Sin embargo, existen múltiples escalas que utilizan diferentes metodologías y diferentes variables para la estimación del riesgo cardiovascular, como es el riesgo de morbimortalidad coronaria (Framingham y Regicor) [8][9][10][11] , riesgo de mortalidad cardio y cerebrovascular (SCORE) 12 , riesgo de morbi-mortalidad cardio y cerebrovascular (European Society Hypertension) 7 , así como escalas especificas para diabéticos (UKPDSRisk) 13 . Los riesgos estimados por las diferentes escalas no siempre coinciden y pueden originar cierta confusión y dificultar su aplicabilidad practica, como se ha podido observar en diferentes estudios [14][15][16][17][18][19][20][21] .…”

Section: Introductionunclassified

Riesgo cardiovascular del paciente hipertenso con seguimiento prolongado en atención primaria: El efecto del envejecimiento (Ciclo Risk Study)

Gómez‐Marcos¹,

González-Elena²,

Maderuelo‐Fernández³

et al. 2007

Rev. Esp. Salud Publica

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RESUMENFundamento La evolución del riesgo cardiovascular estimado, puede servir para valorar la efectividad de las diferentes intervenciones terapéuticas que se realizan en pacientes con seguimiento habitual en las consultas del médico de familia. El objetivo de este trabajo es comparar diferentes sistemas de evaluación del efecto de las intervenciones preventivas en la evolución del riesgo coronario en el seguimiento a largo plazo de personas hipertensas en Atención Primaria.Métodos: Estudio descriptivo longitudinal con seguimiento de 8.42 pacientes hipertensos de 34 a 70 años durante 6 años en dos centros de atención primaria, con una intervención de mejora de calidad (ciclo de mejora) en el último año en uno de ellos. El seguimiento mínimo en atención primaria previo al inicio del estudio fue de dos años. Las variables principales fueron edad y sexo, presión arterial, lípidos, tabaquismo, diabetes y riesgo cardiovascular (RCV)(Framingham-Wilson) en la situación real y considerando constante la edad en el primer supuesto y los factores de riesgo en el segundo y el riesgo relativo.Resultados: Se encontró un descenso de la presión arterial sistólica y diastólica de 11,78 mmHg (IC95%:10,51-13,05) y 8,83 mmHg (IC95%:8,13-9,53) respectivamente y LDL-Colesterol 15,94 mg/dl (IC95%:11,77-20,12), un ascenso del HDLColesterol de 7,53 mg/dl (IC95:6,39-8,66), disminución del tabaquismo del 31% y un aumento de diabéticos. El riego coronario disminuyó 1,40(IC95%:0,87-1,93) puntos porcentuales, el RCV con edad constante descendió 3,84(IC95%:3,35-4,33) y con factores de riesgo constantes incrementó 3,06(IC95%:2,82-3,29). El Riesgo relativo descendió de 2,50 a 1,85.Conclusiones: El envejecimiento puede enmascarar el efecto logrado por la atención sanitaria en el control del riesgo cardiovascular absoluto. El riesgo relativo podría ser una alternativa para monitorizar el seguimiento.Palabras clave: Hipertensión. Riesgo coronario. Envejecimiento. Atención primaria de salud. ABSTRACT Cardiovascular Risk of Hypertensive People with Long-Range Monitoring. The Effect of Aging (Ciclo Risk Study)Background: The evolution of estimated cardiovascular risk can be for evaluating the effectiveness of the different treatment interventions which are carried out on patients with regular follow-up by family physicians. This study is aimed at evaluating the effect of aging on the evolution of cardiovascular risk among hypertensive patients with long-range Primary Care monitoring.Methods: Longitudinal, descriptive study with monitoring of 842 hypertensive patients within the 34-70 age range at two primary care centers, with a quality improvement intervention (improvement cycle) during the last year at one of these centers. The main variables were age and gender, blood pressure, lipids, smoking habit, diabetes and cardiovascular risk (CVR) (Framingham-Wilson) in the real-life situation and considering the age constant in the first case, and the risk factors in the second, plus the relative risk.Results: A drop was found in the systolic and diast...

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Comparación de las tablas REGICOR y SCORE para la clasificación del riesgo cardiovascular y la identificación de pacientes candidatos a tratamiento hipolipemiante o antihipertensivo

Cited by 44 publications

References 27 publications

Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Riesgo cardiovascular del paciente hipertenso con seguimiento prolongado en atención primaria: El efecto del envejecimiento (Ciclo Risk Study)

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