Unique new scoring system can predict risk of death from cardiovascular disease

July 12, 2001

A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomised controlled trials BMJ Volume 323, pp 75-81

A unique new scoring system for assessing a patient's risk of death from cardiovascular disease is revealed in this week's BMJ. The score will help physicians determine a patient's need for drugs to reduce blood pressure (antihypertensive drugs) and other strategies for improving cardiovascular health.

The score is based on information from eight large trials of antihypertensive drugs, involving over 47,000 men and women across Europe and North America. It uses 11 risk factors, including age, sex, systolic blood pressure and total cholesterol levels, smoking, and diabetes, to quantify an adult's risk of death from cardiovascular heart disease. Points are added for each factor according to its association with risk and patients can be classified simply as high or low risk compared with others of the same age and sex.

Age is a particularly strong risk factor - a woman aged 60-64 has 23 extra points compared with a woman aged 35-39. Sex is also important, with men having 12 extra points. Smoking attributed more in women and younger age groups. In women, cholesterol levels mattered less than in men, whereas diabetes had more of an effect.

As the score is based on a large group of patients in controlled trials of antihypertensive drugs, it has wide applicability in general practices and hypertension clinics, providing a simple means of quantifying a patient's risk of cardiovascular disease based on what should be routinely available information, conclude the authors.


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