基层医疗中的心血管风险评估。
Assessment of cardiovascular risk in primary health care.
机构信息
Central Satakunta Health Federation of Municipalities, Harjavalta, Finland. paivi.e.korhonen@fi mnet.fi
出版信息
Scand J Prim Health Care. 2012 Jun;30(2):101-6. doi: 10.3109/02813432.2012.675564.
OBJECTIVE
This study aimed at investigating whether cardiovascular risk factors and their impact on total risk estimation differ between men and women.
DESIGN
Cross-sectional cohort study.
SUBJECTS
Finnish cardiovascular risk subjects (n = 904) without established cardiovascular disease, renal disease, or known diabetes.
MAIN OUTCOME MEASURES
Ankle-brachial index (ABI), estimated glomerular filtration rate (eGFR), oral glucose tolerance test, and total cardiovascular risk using SCORE risk charts.
RESULTS
According to the SCORE risk charts, 27.0% (95% CI 23.1-31.2) of the women and 63.1% (95% CI 58.3-67.7) of the men (p < 0.001) were classified as high-risk subjects. Of the women classified as low-risk subjects according to SCORE, 25% had either subclinical peripheral arterial disease or renal insufficiency.
CONCLUSIONS
The SCORE system does not take into account cardiovascular risk factors typical in women, and thus underestimates their total cardiovascular risk. Measurement of ABI and eGFR in primary care might improve cardiovascular risk assessment. especially in women.
目的
本研究旨在探讨心血管危险因素及其对总体风险评估的影响在男性和女性之间是否存在差异。
设计
横断面队列研究。
受试者
无已确诊心血管疾病、肾脏疾病或已知糖尿病的芬兰心血管风险受试者（n=904）。
主要观察指标
踝臂指数（ABI）、估算肾小球滤过率（eGFR）、口服葡萄糖耐量试验以及使用 SCORE 风险图表评估的总体心血管风险。
结果
根据 SCORE 风险图表，27.0%（95%置信区间 23.1-31.2）的女性和 63.1%（95%置信区间 58.3-67.7）的男性（p<0.001）被归类为高风险受试者。在根据 SCORE 分类为低风险的女性中，25%存在亚临床外周动脉疾病或肾功能不全。
结论
SCORE 系统没有考虑到女性特有的心血管危险因素，因此低估了她们的总体心血管风险。在初级保健中测量 ABI 和 eGFR 可能会改善心血管风险评估，尤其是在女性中。
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