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Qualifiers

HeartScore Europe



Risk estimation using SCORE: Qualifiers

The charts should be used in the light of the clinician’s knowledge and judgement, especially with regard to local conditions.

As with all risk estimation systems, risk will be overestimated in countries with a falling CVD mortality rate, and under estimated if it is rising.

At any given age, risk appears lower for women than men. This is misleading since, ultimately, more women than men die from CVD. Inspection of the charts shows that their risk is merely deferred by 10 years.

Risk may be higher than indicated in the chart in:

  • Sedentary or obese subjects, especially those with central obesity
  • Those with a strong family history of premature CVD
  • The socially deprived
  • Subjects with diabetes- risk may be 5 fold higher in women with diabetes and 3 fold higher in men with diabetes compared to those without diabetes
  • Those with low HDL cholesterol or high triglycerides
  • Asymptomatic subjects with evidence of pre-clinical atherosclerosis, for example a reduced ankle-brachial index or on imaging such as carotid ultrasonography or CT scanning.