Predicting 10-Year Risk of Fatal Cardiovascular Disease in Germany: An Update Based on the SCORE-Deutschland Risk Charts.
Estimation of absolute risk of cardiovascular disease (CVD), preferably with population-specific risk charts, has become a cornerstone of CVD primary prevention. Regular recalibration of risk charts may be necessary due to decreasing CVD rates and CVD risk factor levels. The SCORE risk charts for fatal CVD risk assessment were first calibrated for Germany with 1998 risk factor level data and 1999 mortality statistics. We present an update of these risk charts based on the SCORE methodology including estimates of relative risks from SCORE, risk factor levels from the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) and official mortality statistics from 2012. Competing risks methods were applied and estimates were independently validated. Updated risk charts were calculated based on cholesterol, smoking, systolic blood pressure risk factor levels, sex and 5-year age-groups. The absolute 10-year risk estimates of fatal CVD were lower according to the updated risk charts compared to the first calibration for Germany. In a nationwide sample of 3062 adults aged 40-65 years free of major CVD from DEGS1, the mean 10-year risk of fatal CVD estimated by the updated charts was lower by 29% and the estimated proportion of high risk people (10-year risk > = 5%) by 50% compared to the older risk charts. This recalibration shows a need for regular updates of risk charts according to changes in mortality and risk factor levels in order to sustain the identification of people with a high CVD risk.
Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
Viktoria
V
Rücker
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Ulrich
U
Keil
Department of Epidemiology and Public Health, Department of Statistics, University College Cork, Cork, Ireland.
Anthony P
AP
Fitzgerald
Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.|Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany.
Uwe
U
Malzahn
Institute of Public Health, Charité ‒ Universitätsmedizin Berlin, Berlin, Germany.
Christof
C
Prugger
Department of Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center Würzburg, University Würzburg, Würzburg, Germany.
Georg
G
Ertl
Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.|Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center Würzburg, University Würzburg, Würzburg, Germany.
Peter U
PU
Heuschmann
Department of Epidemiology and Health Monitoring, Robert Koch Institute Berlin, Berlin, Germany.|DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany.
Hannelore
H
Neuhauser
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012307:Risk Factors