Nelson, MR and Ramsay, E and Ryan, P and Willson, K and Tonkin, AM and Wing, L and Simons, L and Reid, CM, A score for the prediction of cardiovascular events in the hypertensive aged, American Journal of Hypertension, 25, (2) pp. 190-194. ISSN 1941-7225 (2012) [Refereed Article]
Copyright Statement: © 2011 Nature Publishing Group Official URL field: http://www.nature.com/
Background: With few exceptions, tools used to estimate cardiovascular disease (CVD) risk in those without prior events are based mainly on data from middle-aged subjects. Given the ever increasing number of older people, many with hypertension, a risk score relevant to this group is warranted. Our aim was to develop a cardiovascular risk equation suitable for risk prediction in elderly, hypertensive populations.
Methods: We utilized cardiovascular end point data from 4.1 years median follow-up in 5,426 hypertensive subjects without previous CVD from the Second Australian National Blood Pressure Study (ANBP2). Our risk model, based on Cox regression, was developed using 75% of subjects without evident CVD (n = 4,072), randomly selected and stratified by age and gender, and internally validated using the remaining 25%. The model was also externally validated against the Dubbo Study dataset.
Results: The final model included sex, age, physical activity in the 2 weeks prior to entry into study, family history, use of anticoagulants, centrally acting antihypertensive agents or diabetes medication, and an interaction term for sex and diabetes medication. The C-statistic was 0.65 (0.62–0.67) for our predictive model on the model development dataset and 0.62 (0.57–0.67) on the internal validation dataset. The Dubbo Data C-statistic for CVD was 0.68 (95% CI 0.65–0.71).
Conclusions: All models performed similarly. Because of greater ease of implementation, we recommend that existing algorithms be extended into older age groups.
|Item Type:||Refereed Article|
|Keywords:||aged, algorithms, blood pressure, cardiovascular diseases, hypertension, risk assessment|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|Author:||Nelson, MR (Professor Mark Nelson)|
|Year Published:||2012 (online first 2011)|
|Funding Support:||National Health and Medical Research Council (490042)|
|Web of Science® Times Cited:||4|
|Deposited By:||Menzies Institute for Medical Research|
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