[风险SCORE模型在地中海血压高血压人口中的预测有效性]
Francisco J Sanz-Garcia1, José A Quesada2, Concepción Carratala-Munuera2
1Departamento de Medicina Clínica, Universidad Miguel Hernández, Campus de San Juan, Alicante, España; Centro de Salud Muro de Alcoy, Muro d'Alcoi, Alicante, España.
概括
在高血压患者中,SCORE尺度对心血管事件和死亡率的预测能力有限. 它经常错误地将个人归类为低风险,强调需要改进风险评估工具.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 公共卫生 公共卫生
背景情况:
- 高血压是导致心血管疾病的全球主要危险因素.
- 准确的心血管风险评估对于指导高血压患者的治疗至关重要.
- 评分尺度 (SCORE) 是一种用于估计心血管风险的工具.
研究的目的:
- 评估SCORE尺度的预测准确性和临床有用性.
- 评估SCORE尺度在高血压患者中预测心血管事件和全因死亡率的能力.
- 确定影响SCORE尺度诊断性能的因素.
主要方法:
- 使用了ESCARVAL-RISK高血压患者队列的数据.
- 使用SCORE尺度计算心血管风险.
- 在5年的随访期内监测心血管事件和死亡率.
- 确定各种SCORE截止点的灵敏度,特异性和预测值.
主要成果:
- 在9834名患者中,治疗开始的5%风险值显示高特异性 (91-92%),但对事件和死亡的敏感性低 (20-22%).
- 评分尺度错误地将经历事件或死亡的高百分比 (78-80%) 的患者归类为低风险.
- 诸如年龄,BMI,视网膜病变和抗凝剂使用等因素降低了尺度的准确性,而女性则提高了它.
结论:
- 在高血压人群中,SCORE尺度表明心血管疾病和整体死亡率的预测能力有限.
- 使用SCORE等级的当前风险分层可能不足以优化高血压的管理.
- 进一步研究更准确的高血压风险预测模型是有必要的.
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