The SCORE risk model applied to recent population surveys in Norway compared to observed mortality in the general population

Abstract

Aims

To compare the predictions of the Systematic Coronary Risk Evaluation (SCORE) high- and low-risk functions applied to a recent population study with observed cardiovascular disease (CVD) mortality estimated from annual official mortality statistics in Norway.

Methods

Data were obtained from large epidemiological surveys conducted in five Norwegian counties in 2000–2003.

Results

A total of 32 251 men and women were investigated (aged 30–31, 40–41, 45–46, and 59–61). For men aged ≥ 59, more than 75% qualified for preventive treatment by having a 10-year risk ≥ 5%. Few women and practically no men younger than 46 years can be considered at high risk according to the SCORE risk prediction models. For men, the high-risk function overestimated and the low-risk model underestimated the CVD mortality as compared to the 10-year risks calculated from official mortality statistics (1999–2003). For women, however, both functions underestimated mortality in young individuals, whereas in the elderly an overestimation was observed.

Conclusions

The risk predictions depended strongly on age and gender. The SCORE high-risk function overestimates the risk of fatal CVD for men in Norway, and before implementation in clinical practice, proper adjustments to national levels are required.