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:
- Low socio-economic status, social isolation or lack of social support
- Obese subjects, especially in case of central obesity
- In case of family history of premature cardiovascular disease
- Subjects with low HDL-cholesterol or high triglycerides
- Subjects with evidence of pre-clinical atheroslcerosys (reduced anckle-brachial index, evidence on imaging as CT coronary calcium score or carotid artery scanning