Differences between SCORE, Framingham Risk Score, and Estimated Pulse Wave Velocity-Based Vascular Age Calculation Methods Based on Data from the Three Generations Health Program in Hungary

Helga Gyöngyösi, Gergő József Szőllősi, Orsolya Csenteri, Zoltán Jancsó, Csaba Móczár, Péter Torzsa, Péter Andréka, Péter Vajer, János Nemcsik

Background:

Early vascular ageing contributes to cardiovascular (CV) morbidity and mortality. There are different possibilities to calculate vascular age including methods based on CV risk scores, but different methods might identify different subjects with early vascular ageing.

Research questions:

We aimed to compare SCORE and Framingham Risk Score (FRS)-based vascular age calculation methods on subjects that were involved in a national screening program in Hungary. We also aimed to compare the distribution of subjects identified with early vascular ageing based on estimated pulse wave velocity (ePWV).

Method:

The Three Generations for Health program focuses on the development of primary health care in Hungary. Vascular ages based on the SCORE and FRS were calculated based on previous publications and were compared with chronological age and with each other in the total population and in patients with hypertension or diabetes. ePWV was calculated based on a method published previously. Supernormal, normal, and early vascular ageing were defined as <10%, 10-90%, and >90% ePWV values for the participants.

Results:

99,231 subjects were involved in the study, 49,191 patients had hypertension (HT) and 15,921 patients had diabetes (DM). The chronological age of the total population was 54.0 (48.0-60.0) years, the SCORE and FRS vascular ages were 59.0 (51.0-66.0) and 64.0 (51-80) years. In HT patients, the chronological, SCORE, and FRS vascular ages were 57.0 (51.0-62.0), 63.0 (56.0-68.0), and 79.0 (64.0-80.0) years. In the DM patients, the chronological, SCORE, and FRS vascular ages were 58.0 (52.0-62.0), 63.0 (56.0-68.0), and 80.0 (76.0-80.0) years. Based on ePWV, the FRS identified patients with elevated vascular age with high sensitivity (97.3%), while in the case of SCORE, the sensitivity was lower (13.3%).

Conclusions:

In conclusion, different vascular age calculation methods can provide different vascular age results in a population-based cohort. The importance of this finding for the implementation in CV preventive strategies requires further studies.

Points for discussion:

#55