Original articleThe ERICE-score: the New Native Cardiovascular Score for the Low-risk and Aged Mediterranean Population of SpainLa ecuación ERICE: la nueva ecuación autóctona de riesgo cardiovascular para una población mediterránea envejecida y de bajo riesgo en España
Section snippets
INTRODUCTION
Current recommendations on the prevention of cardiovascular disease (CVD) in clinical practice encourage health workers to assess the individual's total CVD risk rather than focus on a specific CVD outcome alone.1
Several risk calculators are available in Europe and the United States2, 3, 4, 5 but most of them have been only validated in middle-aged populations or in areas with a relatively high coronary heart disease (CHD) risk and they do not account for the effect of medications used for risk
Data Sources
The ERICE (Ecuación de Riesgo Cardiovascular Española) project comprised seven population-based cohort studies in different geographical areas of Spain. The designs of the original studies have been detailed elsewhere.10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 A collaborative database was created with the individual data from all participants in these 7 cohorts (Table 1).
The studies had to meet the following criteria: single or multicenter surveys of general adult population of both sexes aged ≥
Characteristics of the Study Population
There were 11 800 participants (5413 men and 6387 women) representing 107 915 person-years of follow-up. The median follow-up for the entire study was 9.1 years. A complete follow-up was reported in 11 416 people (96.7% of the total population; 5235 men and 6181 women). We were able to assess the vital status of 100% of cohort participants (Table 1).
Table 2 shows the cardiovascular risk factors and events distribution by sex and study cohort. In total, 1214 CVD events occurred in the entire
DISCUSSION
The ERICE-score is unique in being based on a large cohort of 11 800 Spanish adults, covering a wide age range with uniform and harmonized baseline data. In contrast to previous scores such as the Framingham and EuroSCORE that were based on populations recruited before the 1990s, our estimates are based on more recent cohorts and offer different charts for individuals treated with antihypertensive drugs or not. The CVD incidence rates of this study stress the need of improving primary prevention
CONCLUSIONS
Age was the strongest risk factor for CVD in both sexes, as was well known. In our study, high SBP was the strongest modifiable risk factor of CVD in men, followed by DM and smoking. In women, DM played a crucial role, followed by high SBP and smoking. The contribution of TC to the CVD risk was small in the Spanish population, and in both sexes when considering all age groups in this study. The ERICE offers a new CVD risk estimation system for the Spanish population derived, from the local and
FUNDING
This research was funded by the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, grants G03/065 and PI05/1464; and by RECAVA (Red Temática de Investigación Cooperativa en Enfermedades Cardiovasculares), grant RD06/0014/0015.
CONFLICTS OF INTEREST
None declared.
Acknowledgments
To Rosario Madero from Unidad de Bioestadística, IdiPAZ (Instituto de Investigación Sanitaria del Hospital Universitario La Paz), Hospital Universitario La Paz, Madrid and to Nuria Soriano from Centre d’Atenció Primària Sardenya, Barcelona for statistical assistance; to Margarita Alonso Arroyo from IdiPAZ, Madrid and Teresa R. Pérez Castro from Instituto Universitario de Ciencias de la Salud, Universidad de A Coruña for data management. To Ana Isabel Ortega for editorial assistance.
References (40)
- et al.
Value and limitations of existing scores for the assessment of cardiovascular risk. A review for clinicians
J Am Coll Cardiol
(2009) - et al.
Prevalencia, distribución y variabilidad geográfica de los principales factores de riesgo cardiovascular en España. Análisis agrupado de datos individuales de estudios epidemiológicos poblacionales: estudio ERICE
Rev Esp Cardiol
(2008) - et al.
Prevalencia de factores de riesgo cardiovascular en las Islas Baleares (estudio CORSAIB)
Rev Esp Cardiol
(2005) - et al.
Prevalencia de diabetes mellitus y su asociación a otros factores de riesgo cardiovascular en la provincia de Albacete. Grupo de Enfermedades Vasculares de Albacete (GEVA)
Aten Primaria
(2000) - et al.
Factores de riesgo cardiovascular en una población rural de Castilla-La Mancha
Rev Esp Cardiol
(1999) - et al.
Validez relativa de la estimación del riesgo cardiovascular a 10 años en una cohorte poblacional del estudio REGICOR
Rev Esp Cardiol
(2011) - et al.
Calibración de la tabla SCORE de riesgo cardiovascular para España
Rev Esp Cardiol
(2007) - et al.
Prediction of mortality risk in the elderly
Am J Med
(2006) - et al.
Impacto de la utilización de las diferentes tablas SCORE en el cálculo del riesgo cardiovascular
Rev Esp Cardiol
(2014) Las funciones de riesgo cardiovascular: utilidades y limitaciones
Rev Esp Cardiol
(2014)
Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: The FRESCO Study
Prev Med
European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts)
Eur Heart J
Prediction of coronary heart disease in Europe. The 2nd report of the WHO-ERICA Project
Eur Heart J
Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the Prospective Cardiovascular Munster (PROCAM) study
Circulation
Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project
Eur Heart J
Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2
BMJ
Cardiovascular risk scores do not account for the effect of treatment: a review
Heart
Validity of an adaptation of the Framingham Cardiovascular Risk Function: the VERIFICA Study
J Epidemiol Community Health
Favorable cardiovascular risk profile and 10-year coronary heart disease incidence in women and men: results from the Progetto CUORE
Eur J Cardiovasc Prev Rehabil
El proyecto EPICARDIAN: un estudio de cohortes sobre enfermedades y factores de riesgo cardiovascular en ancianos españoles: consideraciones metodológicas y principales hallazgos demográficos
Rev Esp Salud Publica
Cited by (0)
- 1
See members of the ERICE study group in the Appendix of the supplementary material.