Selmer Randi, Lindman Anja Schou, Tverdal Aage, Pedersen Jan I, Njølstad Inger, Veierød Marit B
Divisjon for epidemiologi, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo.
Tidsskr Nor Laegeforen. 2008 Jan 31;128(3):286-90.
Guidelines for prevention of cardiovascular disease (CVD) include calculation of total risk. A new risk model based on updated Norwegian data is needed, as the European SCORE function overestimates the risk of fatal CVD in Norway. NORRISK for 10-year CVD mortality is presented. It includes gender, age and smoking and levels of systolic blood pressure and serumtotal cholesterol.
NORRISK is based on national age- and sex specific mortality rates from Statistics Norway (1999-2003), mean levels of risk factors from Norwegian Health Surveys (2000-03) and relative risks from mortality follow-up of Norwegian Cardiovascular Screenings (1985-2002). The model is adjusted to the mortality level in the period 1999-2003 and is compared with the SCORE model.
10-year risk estimates calculated from NORRISK fall between SCORE high- and low-risk estimates and increase strongly with age. Very few persons below 50 years of age have a 10-year risk above 5% (European limit for high risk). More than half of men aged 60 years have estimated risks above this limit, while only 7% of 60-year-old women exceed the limit. Even if the risk limit is reduced to 1% for younger age groups, very few women below 50 years of age have risks above the limit.
NORRISK is more adapted to the current situation in Norway than the SCORE model and may be a useful and relevant tool in Norwegian clinical practice.
心血管疾病(CVD)预防指南包括总体风险计算。由于欧洲SCORE函数高估了挪威致命性心血管疾病的风险,因此需要一个基于挪威最新数据的新风险模型。本文介绍了用于预测10年心血管疾病死亡率的NORRISK模型。该模型纳入了性别、年龄、吸烟状况、收缩压水平和血清总胆固醇水平等因素。
NORRISK模型基于挪威统计局提供的全国年龄和性别特异性死亡率数据(1999 - 2003年)、挪威健康调查中的风险因素平均水平数据(2000 - 2003年)以及挪威心血管筛查死亡率随访的相对风险数据(1985 - 2002年)。该模型根据1999 - 2003年期间的死亡率水平进行了调整,并与SCORE模型进行了比较。
根据NORRISK模型计算出的10年风险估计值介于SCORE模型的高风险和低风险估计值之间,并且随年龄增长而显著增加。50岁以下人群中,10年风险高于5%(欧洲高风险限值)的人数极少。60岁男性中,超过一半的人估计风险高于此限值,而60岁女性中只有%超过该限值。即使将年轻年龄组的风险限值降低到1%,50岁以下女性中风险高于该限值的人数也极少。
与SCORE模型相比,NORRISK模型更适合挪威的当前情况,可能是挪威临床实践中一个有用且相关的工具。