[Cardiovascular risk percentiles avoid overestimation or underestimation of risk calculated by the SCORE risk function]. / La adopción de los percentiles de riesgo cardiovascular evita la sobreestimación o infraestimación del riesgo cardiovascular calculado con el SCORE.

BACKGROUND: Cardiovascular risk evaluation is of the utmost importance for treatment of patients with cardiovascular risk factors. There are various scales or equations and they can be adapted to a particular population to try to avoid over or under estimation of risk. We propose risk percentiles as a new method of adapting risk scoring systems to our population. METHODS: A cross sectional study of the prevalence of cardiovascular risk factors in the province of Palencia (ERVPA: Cardiovascular Risk Study in Palencia) was conducted. Age, gender, blood pressure, total cholesterol, tobacco consumption and diabetes were evaluated. 514 subjects aged 20 - 79 taken from the general population were studied in 9 health centers from Palencia (Spain). Fatal cardiovascular risk was measured with SCORE project equations. Percentiles were calculated and compared to both equations and a Spearman's correlation coefficient and a kappa agreement coefficient were calculated. RESULTS: The percentages of high risk range from 0% in young subjects to 92% in males over the age of 70 and 67% in females over the age of 70. The concordance with high risk country equations has a kappa coefficient of 0.741. Concordance varies greatly with age and gender. On comparing the percentiles, the concordance between both equations is almost absolute. CONCLUSIONS: Adopting risk percentiles as a method of cardiovascular risk evaluation permits us to adapt any risk equation to a particular area and avoids underestimation or overestimation of risk. Risk percentiles allow us to extrapolate absolute risk for any age.

La adopción de los percentiles de riesgo cardiovascular evita la sobreestimación o infraestimación del riesgo cardiovascular calculado con el score / Cardiovascular risk percentiles avoid overestimation or underestimation of risk calculated by the SCORE risk function

Fundamento: La evaluación del riesgo cardiovascular es demáxima importancia para un correcto tratamiento de pacientes conriesgo. Hay varias ecuaciones de riesgo que pueden ser adaptadas auna población para evitar la sobre o infraestimación del riesgo. Seproponen a los percentiles de riesgo como un nuevo método paraadaptar los sistemas de valoración del riesgo a nuestra población.Métodos: Se ha realizado un estudio transversal de factores deriesgo cardiovascular en Palencia (ERVPA: Estudio de Riesgo Vascularen PAlencia). Se han registrado las variables edad, sexo, tabaquismo,tensión arterial, diabetes y colesterolemia. Se han estudiado514 sujetos entre 20 y 79 años procedentes de 9 centros de salud delárea sanitaria. Se ha calculado el riesgo cardiovascular fatal segúnlas ecuaciones del proyecto SCORE. Se han calculado y comparadolos percentiles obtenidos con cada ecuación, mediante el cálculo delos coeficientes de Spearman y kappa.Resultados: Los porcentajes de sujetos con riesgo alto varíanentre el 0% en jóvenes hasta el 92% en los varones y el 67% en lasmujeres mayores de 70 años. El coeficiente kappa entre las ecuacionespara países de bajo y alto riesgo es de 0.741. Dicha concordanciavaría de forma importante según el sexo y la edad. La concordanciaentre los percentiles es casi total. Conclusiones: Los percentiles de riesgo es un método de evaluacióndel riesgo que permite adaptar cualquier ecuación a unapoblación particular evitando la sobre o infraestimación del riesgo ypermiten extrapolar el riesgo a cualquier edad

Background: Cardiovascular risk evaluation is of the utmostimportance for treatment of patients with cardiovascular risk factors.There are various scales or equations and they can be adaptedto a particular population to try to avoid over or under estimation ofrisk. We propose risk percentiles as a new method of adapting riskscoring systems to our population.Methods: A cross sectional study of the prevalence of cardiovascularrisk factors in the province of Palencia (ERVPA: CardiovascularRisk Study in Palencia) was conducted. Age, gender, bloodpressure, total cholesterol, tobacco consumption and diabetes wereevaluated. 514 subjects aged 20 - 79 taken from the general populationwere studied in 9 health centers from Palencia (Spain). Fatalcardiovascular risk was measured with SCORE project equations.Percentiles were calculated and compared to both equations and aSpearman´s correlation coefficient and a kappa agreement coefficientwere calculated.Results: The percentages of high risk range from 0% in youngsubjects to 92% in males over the age of 70 and 67% in females overthe age of 70. The concordance with high risk country equations hasa kappa coefficient of 0.741. Concordance varies greatly with ageand gender. On comparing the percentiles, the concordance betweenboth equations is almost absolute. Conclusions: Adopting risk percentiles as a method of cardiovascularrisk evaluation permits us to adapt any risk equation to aparticular area and avoids underestimation or overestimation of risk.Risk percentiles allow us to extrapolate absolute risk for any age