title: [Cardiovascular risk percentiles avoid overestimation or underestimation of risk calculated by the SCORE risk function].
abstract: BACKGROUND
  Cardiovascular risk evaluation is of the utmost importance for treatment of patients with cardiovascular risk factors. There are various scales or equations and they can be adapted to a particular population to try to avoid over or under estimation of risk. We propose risk percentiles as a new method of adapting risk scoring systems to our population.
  
  
  METHODS
  A cross sectional study of the prevalence of cardiovascular risk factors in the province of Palencia (ERVPA: Cardiovascular Risk Study in Palencia) was conducted. Age, gender, blood pressure, total cholesterol, tobacco consumption and diabetes were evaluated. 514 subjects aged 20 - 79 taken from the general population were studied in 9 health centers from Palencia (Spain). Fatal cardiovascular risk was measured with SCORE project equations. Percentiles were calculated and compared to both equations and a Spearman's correlation coefficient and a kappa agreement coefficient were calculated.
  
  
  RESULTS
  The percentages of high risk range from 0% in young subjects to 92% in males over the age of 70 and 67% in females over the age of 70. The concordance with high risk country equations has a kappa coefficient of 0.741. Concordance varies greatly with age and gender. On comparing the percentiles, the concordance between both equations is almost absolute.
  
  
  CONCLUSIONS
  Adopting risk percentiles as a method of cardiovascular risk evaluation permits us to adapt any risk equation to a particular area and avoids underestimation or overestimation of risk. Risk percentiles allow us to extrapolate absolute risk for any age.
authors.affiliation: Servicio de Medicina Interna, Complejo Hospitalario de Palencia. jcuendem@medynet.com
authors.forename: Jose I
authors.initials: JI
authors.lastname: Cuende
authors.forename: Alfredo
authors.initials: A
authors.lastname: Acebal
authors.forename: Azucena
authors.initials: A
authors.lastname: Carrera-Camarón
authors.forename: Florentino
authors.initials: F
authors.lastname: Salado-Cuadrado
authors.forename: Francisco
authors.initials: F
authors.lastname: Díez-Cordero
authors.forename: Ismael
authors.initials: I
authors.lastname: Blanco-Urzáiz
authors.forename: María
authors.initials: M
authors.lastname: Redondo-Valdeolmillos
authors.forename: Nélida
authors.initials: N
authors.lastname: García-Vallejo
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*