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[西班牙阿斯图里亚斯45至65岁男性样本中SCORE模型与弗明汉模型在计算高心血管风险方面的比较]

[Comparison of the SCORE and Framingham models in calculating high cardiovascular risk for a sample of males within the 45-65 age range in Asturias, Spain].

作者信息

Alvarez Cosmea Artemio, Díaz González Luis, López Fernández Vicente, Prieto Díaz Miguel Angel, Suárez García Saúl

机构信息

Centro de Salud Ventanielles-Colloto, Oviedo, Principado de Asturias.

出版信息

Rev Esp Salud Publica. 2005 Jul-Aug;79(4):465-73. doi: 10.1590/s1135-57272005000400004.

Abstract

BACKGROUND

The Spanish Interdisciplinary Committee for Cardiovascular Prevention has recently drafted a consensus for adapting the European Cardiovascular Prevention Guide to the Spanish population, using SCORE as the risk-calculation method. This study is aimed as ascertaining the differences involved in changing over from the Framingham to the SCORE criterion in the classification of males within the high-risk group.

METHODS

Descriptive cross-sectional study conducted in primary care. A total of 379 males within the 45-65 age range, corresponding to four (4) groups from general practitioners from three healthcare centers in the Principality of Asturias.

MAIN MEASUREMENTS

calculation of the cardiovascular risk and high-risk prevalence by the conventional Framingham method and according to SCORE. High-risk prevalence curve estimated by logic regression.

RESULTS

The high-risk prevalence according to the Framingham equation was 24% (CI95%=19.9-28.7) and was 17.9% (CI95%=14.3-22.3) for SCORE, the difference being statistically significant (p=0.02). The SCORE model shows lower prevalences among subjects under age 60 and higher for those over age 60. Among male smokers, SCORE shows lower prevalences among individuals under 58 years of age, the high-risk males with Framingham and low-risk with SCORE being younger, smokers and having lower average blood pressure figures and moderate cholesterol figures.

CONCLUSIONS

On applying the SCORE model, we classify fewer males as high-risk, especially among those under 58 years of age who are smokers having moderate cholesterol figures than when the Framingham scale is used.

摘要

背景

西班牙心血管疾病预防跨学科委员会最近起草了一项共识,旨在根据西班牙人群的情况调整欧洲心血管疾病预防指南,采用SCORE作为风险计算方法。本研究旨在确定在高危组男性分类中从弗明汉姆标准转换为SCORE标准所涉及的差异。

方法

在初级保健机构进行描述性横断面研究。共有379名年龄在45至65岁之间的男性,来自阿斯图里亚斯公国三个医疗中心的四组全科医生。

主要测量指标

通过传统的弗明汉姆方法和SCORE计算心血管疾病风险和高危患病率。通过逻辑回归估计高危患病率曲线。

结果

根据弗明汉姆方程计算的高危患病率为24%(95%CI=19.9-28.7),SCORE为17.9%(95%CI=14.3-22.3),差异具有统计学意义(p=0.02)。SCORE模型在60岁以下人群中的患病率较低,在60岁以上人群中较高。在男性吸烟者中,SCORE在58岁以下个体中的患病率较低,弗明汉姆标准下的高危男性和SCORE标准下的低危男性更年轻,吸烟,平均血压较低,胆固醇水平中等。

结论

应用SCORE模型时,我们将较少男性归类为高危,特别是在58岁以下、吸烟且胆固醇水平中等的人群中,与使用弗明汉姆量表时相比。

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