[The application of the SCORE charts to advanced age males triple the number of high-risk subjects compared to the Framingham function]

Abstract

Background and objective: The Framingham function, recommended by the National Cholesterol Education Program in its document Adult Treatment Panel III (ATP III), and the risk charts of the Systematic Coronary Risk Evaluation (SCORE) program are the most used functions for risk stratification. In both, intensive hygienic and therapeutic measures are recommended for high risk individuals. The objective of the present study was to compare the risk stratification obtained with both functions in a population of subjects older than 60 years.

Subjects and method: 1001 non-diabetic subjects between 60 and 79 years old (mean: 69 years, 67% female) with no evidence of cardiovascular disease were included in the study. Participants were classified as low, moderate or high risk by ATP-III (< 10%, 10-20% y > 20% of risk at 10 years, respectively) and by SCORE (< 3%, 3-4% y > or = 5% of risk at 10 years respectively).

Results: 11.7% of the population was classified as high risk by Framingham and 17.6% by SCORE. Only 5% of the females were classified as high risk with either function. In males, 16.7% and a 44.4% were classified as high risk by Framingham and SCORE respectively. The results did not differ by age group. A 39% of males and a 20% of females were candidates to hypolipidemic treatment as recommended by SCORE guidelines.

Conclusions: Compared to Framingham function, the application of SCORE charts to spanish males over 60 years triplicate the number of high risk individuals and candidates to intensive risk factor treatment.