Departamento de Salud Internacional, Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain.
Instituto Universitario de Ciencias de la Salud, Universidad de La Coruña, A Coruña, Spain.
Rev Clin Esp (Barc). 2022 Jan;222(1):13-21. doi: 10.1016/j.rceng.2021.05.003. Epub 2021 Sep 24.
Cardiovascular risk estimation in people over 70 years of age is problematic. Most scores have been created based on cohorts of middle-aged people, with an underrepresentation of older adults. The predictive power of classical cardiovascular risk factors declines with age. The aim of this work is to develop a specific score for estimating cardiovascular risk among the elderly population in Spain.
This work is a population-based cohort established in 1995.
Three geographical areas of Spain (Madrid, Ávila, and Lugo).
3,729 people older than 64 years with no cardiovascular diseases (CVD) at baseline.
Suspected fatal and nonfatal CVD (both coronary heart disease and stroke) were investigated annually and confirmed using the WHO-MONICA criteria. All participants were followed-up on until occurrence of a first CVD event, until death, or until December 31, 2015.
Age was the strongest predictor of CVD at 10 years in both men and women. In men, variables associated with CVD were high blood pressure treatment (HR: 1.35; 95% CI: 1.067-1.710), diabetes (HR: 1.359; 95% CI: 0.997-1.852), and smoking (HR: 1.207; 95% CI: 0.945-1.541) and in women, the variables were smoking (HR: 1.881; 95% CI: 1.356-2.609) and diabetes (HR: 1.285; 95% CI: 0.967-1.707). Total cholesterol did not increase the risk of CVD in men or women. However, total cholesterol levels >200 mg/dL were inversely associated with 10-year risk of CVD in men and women.
In elderly Spanish men, total CVD at 10 years is significantly increased by age, diabetes, and antihypertensive treatment and in elderly Spanish women by diabetes and smoking. Total cholesterol levels did not increase the risk of CVD, particularly in males.
对 70 岁以上人群进行心血管风险评估存在问题。大多数评分都是基于中年人群的队列建立的，老年人的代表性不足。经典心血管危险因素的预测能力随年龄增长而下降。本研究旨在为西班牙老年人群制定特定的心血管风险评分。
这是一项基于人群的队列研究，于 1995 年建立。
西班牙三个地理区域（马德里、阿维拉和卢戈）。
3729 名年龄在 64 岁以上且基线时无心血管疾病（CVD）的人群。
每年调查可疑的致命和非致命 CVD（包括冠心病和中风），并使用世界卫生组织- MONICA 标准进行确认。所有参与者均随访至首次发生 CVD 事件、死亡或 2015 年 12 月 31 日。
年龄是男性和女性 CVD 10 年的最强预测因素。在男性中，与 CVD 相关的变量包括高血压治疗（HR：1.35；95%CI：1.067-1.710）、糖尿病（HR：1.359；95%CI：0.997-1.852）和吸烟（HR：1.207；95%CI：0.945-1.541），而在女性中，相关变量为吸烟（HR：1.881；95%CI：1.356-2.609）和糖尿病（HR：1.285；95%CI：0.967-1.707）。总胆固醇并未增加男性或女性的 CVD 风险。然而，男性和女性总胆固醇水平>200mg/dL 与 10 年 CVD 风险呈负相关。
在西班牙老年男性中，总 CVD 在 10 年内显著增加，与年龄、糖尿病和降压治疗有关，而在西班牙老年女性中，总 CVD 则与糖尿病和吸烟有关。总胆固醇水平并未增加 CVD 的风险，尤其是在男性中。
