• Medicina clinica · Feb 2024

    Predictive validity of the risk SCORE model in a Mediterranean population with arterial hypertension.

    • Francisco J Sanz-Garcia, José A Quesada, Concepción Carratala-Munuera, Domingo Orozco-Beltrán, Vicente F Gil-Guillén, María J Prieto-Castello, Dolores Marhuenda-Amorós, Rafael M Micó Pérez, Felipe Navarro Cremades, Alberto Cordero, Vicente Bertomeu-Gonzalez, and Vicente Arrarte.
    • Departamento de Medicina Clínica, Universidad Miguel Hernández, Campus de San Juan, Alicante, España; Centro de Salud Muro de Alcoy, Muro d'Alcoi, Alicante, España.
    • Med Clin (Barc). 2024 Feb 9; 162 (3): 112117112-117.

    Introduction And ObjectivesHypertension is the most prevalent risk factor globally. Calculation of cardiovascular risk in hypertensive patients before initiation of treatment is recommended. This study aimed to assess the predictive value and clinical utility of the SCORE scale in preventing cardiovascular events and all-cause mortality in patients with hypertension.MethodsPatients with hypertension from the ESCARVAL-RISK cohort were included. Cardiovascular risk was calculated using the SCORE scale. All deaths and cardiovascular events were recorded during a 5-year follow-up period. Sensitivity, specificity and predictive values were calculated for different cut-off points and the effect of different risk factors on the diagnostic accuracy of SCORE charts were assessed.ResultsIn a final cohort of 9834 patients, there were 555 cardiovascular events and 69 deaths. The recommended risk value for initiating drug treatment (5%) had a specificity of 92% for death and 91% for cardiovascular events, and a sensitivity of 20% for death and 22% for cardiovascular events. In addition, the scale classified 80.4% of patients who experienced a cardiovascular event and 78.3% of those who died as low risk. Age, body mass index, retinopathy and anticoagulant therapy were associated with reduced predictive ability of the SCORE scale, while being female was associated with better risk prediction.ConclusionsThe predictive ability of the SCORE scale for cardiovascular disease and total mortality in patients with hypertension is limited.Copyright © 2023 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.

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