Szyndler Anna, Kucharska Wies Awa, Dubiela-D Browska And Elina, Olszanecka Agnieszka, Widecka Justyna, B Czkiewicz Miros Awa, Widecka Katarzyna, Galas Gra Yna, Chlebi Ska Iwona, Sakiewicz Wojciech, Gaciong Zbigniew, Widecka Krystyna, Januszewicz Andrzej, Kawecka-Jaszcz Kalina, Narkiewicz Krzysztof
Hypertension Unit, Dept. Hypertension and Diabetology, Medical University of Gdansk, Poland.
Blood Press. 2011 Dec;20(6):342-7. doi: 10.3109/08037051.2011.587267. Epub 2011 Jun 15.
OBJECTIVE. The aim of the present study was to compare the effectiveness of Systemic COronary Risk Evaluation (SCORE) charts and European Society of Hypertension/European Society of Cardiology (ESH/ESC) hypertension guidelines for identifying high-risk hypertensive patients. METHODS. The data on hypertensive patients was collected using the Polish Hypertension Registry. We enrolled 636 patients (357 females and 279 males, mean age 54.4 (+/-) 7.9 years) from hypertension centres in Poland. RESULTS. Only 3.5% of the subjects had no additional risk factors. Thirty-six per cent of the patients had three or more risk factors. Metabolic syndrome was found in 40.1% of the patients. According to the SCORE charts, 9.0% of females and 27.2% of males had high to very high cardiovascular risk (p < 0.001). Taking into account risk factors and the metabolic syndrome, 55.7% of females and 56.3% of males (p = NS) had high or very high additional cardiovascular risk according to the 2007 ESH/ESC guidelines. For both females and males, the prevalence of high to very high risk was greater (p < 0.001) from the calculation based on the 2007 ESH/ESC guidelines than from the SCORE charts. Fifty-two per cent of patients classified as low to moderate risk according to the SCORE system, had high or very high risk according to the 2007 ESH/ESC guidelines. CONCLUSIONS. The SCORE charts seem to underestimate the burden of the cardiovascular risk among hypertensive patients. The cardiovascular risk, especially in the hypertensive female population, seems to be much higher when estimated according to the 2007 ESH/ESC guidelines.
目的。本研究的目的是比较系统性冠状动脉风险评估（SCORE）图表与欧洲高血压学会/欧洲心脏病学会（ESH/ESC）高血压指南在识别高危高血压患者方面的有效性。方法。使用波兰高血压登记处收集高血压患者的数据。我们从波兰的高血压中心招募了636名患者（357名女性和279名男性，平均年龄54.4（±）7.9岁）。结果。只有3.5%的受试者没有其他风险因素。36%的患者有三个或更多风险因素。40.1%的患者存在代谢综合征。根据SCORE图表，9.0%的女性和27.2%的男性有高至非常高的心血管风险（p<0.001）。根据2007年ESH/ESC指南，考虑到风险因素和代谢综合征，55.7%的女性和56.3%的男性（p=无显著性差异）有高或非常高的额外心血管风险。对于女性和男性，根据2007年ESH/ESC指南计算的高至非常高风险的患病率均高于SCORE图表（p<0.001）。根据SCORE系统分类为低至中度风险的患者中，52%根据2007年ESH/ESC指南有高或非常高的风险。结论。SCORE图表似乎低估了高血压患者心血管风险的负担。根据2007年ESH/ESC指南评估时，心血管风险，尤其是在高血压女性人群中，似乎要高得多。
