title: A six question screen to facilitate primary cardiovascular disease prevention.
abstract: BACKGROUND
  European guidelines on primary prevention of cardiovascular disease (CVD) recommend the SCORE risk charts for determining CVD risk, which include blood pressure and serum cholesterol as risk parameters. To facilitate cost-effective large-scale screening, we aimed to construct a risk score with 'non-invasive' parameters as a first screening step to identify persons at increased CVD risk requiring further risk assessment.
  
  
  METHODS
  We used data of Dutch employees from 25 organisations participating in a health risk assessment between August 2007 and January 2013. Backward multivariate logistic regression analysis was employed to select non-invasive, independent predictors of high CVD risk, defined as the 10-year risk of fatal CVD of ≥5 % based on the SCORE formula. The total CVD risk score was calculated as the summed coefficients of the retained variables.
  
  
  RESULTS
  Data of 6189 male participants was used for the development and validation of the risk score. Age, tobacco use, history of hypertension, alcohol consumption, BMI, and waist circumference were independent predictors of high CVD risk. Ten-fold cross-validation resulted in an area under the curve of 0.95 (SE 0.01, 95 % confidence interval 0.94-0.96). A cut-off score ≥45 on the CVD risk score yielded a sensitivity of 0.93, and a specificity of 0.85.
  
  
  CONCLUSIONS
  We developed a simple, non-invasive risk score that accurately identifies persons at increased CVD risk according to the SCORE formula in a population of working men. The risk score enables a stepwise approach in large screening programmes, strongly reducing the number of persons that require full risk estimation including blood pressure and cholesterol measures.
authors.affiliation: Departments of Internal and Vascular Medicine, Academic Medical Center of the University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. n.v.vanderhoeven@amc.nl.|NIPED Research Foundation, Amsterdam, The Netherlands. n.v.vanderhoeven@amc.nl.
authors.forename: Niels V
authors.initials: NV
authors.lastname: van der Hoeven
authors.affiliation: NIPED Research Foundation, Amsterdam, The Netherlands.
authors.forename: Maurice A J
authors.initials: MA
authors.lastname: Niessen
authors.affiliation: Departments of Internal and Vascular Medicine, Academic Medical Center of the University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Erik S G
authors.initials: ES
authors.lastname: Stroes
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Lex
authors.initials: L
authors.lastname: Burdorf
authors.affiliation: NIPED Research Foundation, Amsterdam, The Netherlands.
authors.forename: Roderik A
authors.initials: RA
authors.lastname: Kraaijenhagen
authors.affiliation: Departments of Internal and Vascular Medicine, Academic Medical Center of the University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Bert-Jan H
authors.initials: BJ
authors.lastname: van den Born
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D011795:Surveys and Questionnaires