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Updated: Jul 5, 2025
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Differences between SCORE, Framingham Risk Score, and Estimated Pulse Wave Velocity-Based Vascular Age Calculation
Helga Gyöngyösi1, Gergő József Szőllősi2,3, Orsolya Csenteri2
1Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary.
Insights
Different methods for calculating vascular age yield varying results, impacting cardiovascular disease risk assessment. The Framingham Risk Score (FRS) demonstrated higher sensitivity in identifying early vascular ageing compared to the SCORE method.
Area of Science:
- Cardiology
- Vascular Biology
- Public Health
Background:
- Early vascular ageing is a significant contributor to cardiovascular morbidity and mortality.
- Existing methods for calculating vascular age, including cardiovascular risk scores, may identify different individuals as having early vascular ageing.
Purpose of the Study:
- To compare vascular age calculations using the SCORE and Framingham Risk Score (FRS) methods.
- To evaluate the distribution of individuals identified with early vascular ageing based on estimated pulse wave velocity (ePWV).
Main Methods:
- Vascular ages were calculated using SCORE and FRS in a large Hungarian national screening program cohort (n=99,231).
- Estimated pulse wave velocity (ePWV) was used to define supernormal, normal, and early vascular ageing.
- Comparisons were made between chronological age, SCORE-based vascular age, FRS-based vascular age, and ePWV-defined vascular age, including in subgroups with hypertension and diabetes.
Main Results:
- The Framingham Risk Score (FRS) identified patients with elevated vascular age with high sensitivity (97.3%) based on ePWV.
- The SCORE method showed significantly lower sensitivity (13.3%) in identifying patients with elevated vascular age based on ePWV.
- FRS-based vascular age was consistently higher than chronological age and SCORE-based vascular age, particularly in patients with hypertension and diabetes.
Conclusions:
- Different vascular age calculation methods produce divergent results in a population-based cohort.
- The Framingham Risk Score (FRS) appears more sensitive than the SCORE method for detecting early vascular ageing when assessed by ePWV.
- Further research is needed to determine the clinical implications of these discrepancies for cardiovascular preventive strategies.
Abstract:
Early vascular ageing contributes to cardiovascular (CV) morbidity and mortality. There are different possibilities to calculate vascular age including methods based on CV risk scores, but different methods might identify different subjects with early vascular ageing. We aimed to compare SCORE and Framingham Risk Score (FRS)-based vascular age calculation methods on subjects that were involved in a national screening program in Hungary. We also aimed to compare the distribution of subjects identified with early vascular ageing based on estimated pulse wave velocity (ePWV). The Three Generations for Health program focuses on the development of primary health care in Hungary. One of the key elements of the program is the identification of risk factors of CV diseases. Vascular ages based on the SCORE and FRS were calculated based on previous publications and were compared with chronological age and with each other in the total population and in patients with hypertension or diabetes. ePWV was calculated based on a method published previously. Supernormal, normal, and early vascular ageing were defined as <10%, 10-90%, and >90% ePWV values for the participants. In total, 99,231 subjects were involved in the study, and among them, 49,191 patients had hypertension (HT) and 15,921 patients had diabetes (DM). The chronological age of the total population was 54.0 (48.0-60.0) years, while the SCORE and FRS vascular ages were 59.0 (51.0-66.0) and 64.0 (51-80) years, respectively. In the HT patients, the chronological, SCORE, and FRS vascular ages were 57.0 (51.0-62.0), 63.0 (56.0-68.0), and 79.0 (64.0-80.0) years, respectively. In the DM patients, the chronological, SCORE, and FRS vascular ages were 58.0 (52.0-62.0), 63.0 (56.0-68.0), and 80.0 (76.0-80.0) years, respectively. Based on ePWV, the FRS identified patients with an elevated vascular age with high sensitivity (97.3%), while in the case of the SCORE, the sensitivity was much lower (13.3%). In conclusion, different vascular age calculation methods can provide different vascular age results in a population-based cohort. The importance of this finding for the implementation in CV preventive strategies requires further studies.
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