Abstract P290: Stroke and Coronary Heart Disease - Predictive Power of Standard Risk Factors Until Old Age
Introduction and Aim: The SCORE model, based on age, sex, current smoking and systolic blood pressure, and serum cholesterol, was created to identify persons at increased risk for fatal cardiovascular disease (CVD) defined as death from coronary heart disease (CHD) or stroke within 10 years. We aimed to examine the short-term and long-term risk for CHD and stroke separately.
Methods and Results: The Primary Prevention cohort study comprising 7174 men free from previous history of CHD, stroke and diabetes and aged 45 to 55 at baseline examination (1970–73) were followed up for 35 years. To estimate the cumulative effect of CHD and stroke, all participants were stratified into one of four risk groups defined by their burden of risk according to the SCORE factors. The 35 year relative risk (RR) for the men with the highest risk compared to those with the lowest was 3.38 (95 % CI 2.84–4.02) for CHD and 1.60 (95% CI 1.28–2.00) for stroke. When adjusted for competing risk the estimated 10 year cumulative risk for high risk individuals was 19.4% for CHD and 3.6% for stroke which increased substantially to 87% and 70% respectively after 35 years.
Conclusions: The 10 year risk for CHD and stroke as calculated by the SCORE factors differs which indicates that the cumulative risk in middle age men based on the SCORE model can effectively be used to predict CHD but not stroke to the same extent. However, over an extended follow-up period until old age, the cumulative risk for stroke increased markedly such that high risk individuals developed a high cumulative risk for both CHD and stroke after 35 years.
- © 2012 by American Heart Association, Inc.