Comparison of the REGICOR and SCORE Function Charts for Classifying Cardiovascular Risk and for Selecting Patients for Hypolipidemic or Antihypertensive Treatment

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

doi:10.1016/s1885-5857(07)60126-1

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…In Spain, some authors reported a prevalence of high risk in asymptomatic and non-diabetic individuals ranging from 4.1-9.2% (Gonzalez et al 2006;Buitrago et al 2007;Fornasini et al 2006). In one of the studies, the prevalence of high-risk individuals raises to 29.2% when diabetic patients were included (Fornasini et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Assessment of global cardiovascular risk and risk factors in Portugal according to the SCORE® model

et al. 2008

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Background/objective Cardiovascular diseases (CVD) are the leading cause of mortality in European countries. This study aimed at estimating the 10-year risk of fatal CVD in Portuguese adults and to assess the prevalence of major cardiovascular risk factors, according to the SCORE® risk prediction system. Subjects and methods A cross-sectional survey was carried out in 60 community pharmacies (CP) from October 2005 to January 2006 in a sample of CP users (≥40 and ≤65 years). Data were collected by patient interviews using a structured questionnaire applied by a trained pharmacist. Results A total of 1,043 individuals were enrolled in the study (participation rate: 91%). The mean age was 53.7 years (SD: 7.1) with a ratio men/women of 0.68. The average risk in the sample was 1.94 (minimum 0, maximum 28, SD=2.69). About 20% of the studied adults were at high risk, of which 39.4% were asymptomatic. CV risk was significantly higher in the oldest age group and in men (p< 0.05). The prevalence of main CV risk factors was: hypertension-54.8%; hypercholesterolemia-63.1%, diabetes-13.4%; smoking-10.4% and obesity-29.0%. About 1/3 of those asked had family history of premature CVD. Mean values of biochemical and clinical parameters were: systolic blood pressure (mmHg): 134.8± 19.7; diastolic blood pressure (mmHg): 81.0±11.4; total cholesterol (mg/dl): 193.8±34.6; body mass index (kg/m 2 ): 28.0±4.5. Conclusions According to SCORE®, about one-fifth of the individuals was classified as high risk, and 7.7% was asymptomatic. CV risk was significantly higher in the oldest age group (55-65 years old) and in men (p<0.05). These results show a high prevalence of some risk factors, particularly hypertension and hypercholesterolemia.

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Section: Discussionmentioning

confidence: 99%

Assessment of global cardiovascular risk and risk factors in Portugal according to the SCORE® model

et al. 2008

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“…Implementing the European guidelines (15) would lead to 23.8% of patients from a primary care facility being considered eligible for lipid-lowering pharmacologic treatment in Spain (25). The proportion of subjects that were medicated at the time of the observation was lower in our study (9.1% vs 18.4%).…”

Section: Discussionmentioning

confidence: 57%

Hypercholesterolemia, eligibility for lipid-lowering therapy and therapeutic success: population-based study in a Portuguese urban population

Alves

Azevedo

2008

European Journal of Endocrinology

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Background: We aimed to estimate i) the prevalence of hypercholesterolemia, ii) the proportion of individuals eligible for treatment with lipid-lowering drugs, and iii) therapeutic success, according to the European guidelines on cardiovascular disease prevention in clinical practice. Design: Population-based cross-sectional study. Methods: We surveyed a representative sample of the population of Porto aged 40-65 years. Trained interviewers collected data from 1215 subjects (789 women) on demographic variables, medical history, and medication using structured questionnaires. A fasting venous blood sample was withdrawn. Subjects were considered low risk or high risk as indicated in the European guidelines. Hypercholesterolemia was defined as total cholesterol (TC) R5 mmol/l or low-density-cholesterol (LDL-C) R3 mmol/l in low-risk subjects, TC R4.5 mmol/l or LDL-C R2.5 mmol/l in high-risk subjects or being medicated with lipid-lowering drugs. Eligibility for treatment was defined as being high risk and having TC R4.5 mmol/l, LDL-C R2.5 mmol/l or being on treatment. We defined therapeutic success as having TC !4.5 mmol/l and LDL-C!2.5 mmol/l among medicated subjects. Results: Overall, 84.9% (95% confidence interval (95% CI): 82.7-86.8) of subjects had hypercholesterolemia and 9.1% (95% CI: 7.5-10.8) were medicated with lipid-lowering drugs. Men were more likely to be eligible for treatment (42.4%) than women (22.4%; ORZ2.69, 95% CI 2.07-3.52). Therapeutic success was less frequent in men (46.8%) than in women (66.7%), (ORZ0.39, 95% CI 0.17-0.87). Conclusion: Strict interpretation of the European guidelines would label 85% of the general population in this age group as hypercholesterolemic and a third eligible for drug treatment. Questions arise regarding medicalization, resource allocation, and sustainability within the healthcare system.

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“…In the present study, we used the Framingham‐REGICOR algorithm for stratifying CHD risk; this is an adaptation of the Framingham function to the Spanish population (the original Framingham function estimates more than double the risk of CHD observed in northeastern Spain). With the ≥10% cutoff point, it classifies a number of individuals as high risk similar to the Framingham risk score and has been validated in the Spanish population .…”

Section: Discussionmentioning

confidence: 99%

Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients

Cuervas-Mons

Herrero

Gómez

et al. 2015

Clinical Transplantation

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The aim of this study was to evaluate the impact of a steroid-free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients. Patients who received a liver transplant were randomized to a modified therapy (n = 58) or a standard regimen (n = 59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p < 0.01) and a higher serum creatinine concentration (p < 0.05) in the modified therapy group. After 12 months, the prevalence of new-onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at one yr post-transplantation was numerically lower in the modified therapy group (0.22 ± 0.42) than in the standard regimen group (0.41 ± 0.67) (p = 0.068). Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (-0.27 ± 2.87) vs. a mild increase (0.17 ± 2.94) in the standard regimen (p = 0.566). In conclusion, a steroid-free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score.

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Comparison of the REGICOR and SCORE Function Charts for Classifying Cardiovascular Risk and for Selecting Patients for Hypolipidemic or Antihypertensive Treatment

Cited by 9 publications

References 38 publications

Assessment of global cardiovascular risk and risk factors in Portugal according to the SCORE® model

Assessment of global cardiovascular risk and risk factors in Portugal according to the SCORE® model

Hypercholesterolemia, eligibility for lipid-lowering therapy and therapeutic success: population-based study in a Portuguese urban population

Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients

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