Global cardiovascular risk stratification: comparison of the Framingham method with the SCORE method in the Mexican...

In the Mexican population we are unaware if the Framingham model is a better system than the SCORE system for stratifying cardiovascular risk. The present study was conducted to compare risk stratification with the Framingham tables using the same procedure but using the SCORE, with the aim of recommending the use of the most appropriate method.

We analyzed a database of apparently healthy workers from the Mexico City General Hospital included in the study group "PRIT" (Prevalencia de Factores de Riesgo de Infarto del Miocardio en Trabajadores del Hospital General de México) and we calculated the risk in each simultaneously with the Framingham method and the SCORE method.

It was possible to perform risk calculation with both methods in 1990 subjects from a total of 5803 PRITHGM study participants. When using the SCORE method, we stratified 1853 patients into low risk, 133 into medium risk and 4 into high risk. The Framingham method qualified 1586 subjects as low risk, 268 as medium risk and 130 as high risk. Concordance between scales to classify both patients according to the same risk was 98% in those classified as low risk, 19.4% among those classified as intermediate risk and only 3% in those classified as high risk.

According to our results, it seems more appropriate in our country to recommend the Framingham model for calculating cardiovascular risk due to the fact that the SCORE model underestimated risk.