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A score for the prediction of cardiovascular events in the hypertensive aged

Citation

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]


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Copyright Statement

Copyright Statement: © 2011 Nature Publishing Group Official URL field: http://www.nature.com/

DOI: doi:10.1038/ajh.2011.192

Abstract

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 Details

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 Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Nelson, MR (Professor Mark Nelson)
ID Code:75283
Year Published:2012 (online first 2011)
Funding Support:National Health and Medical Research Council (490042)
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2012-01-19
Last Modified:2013-11-15
Downloads:0

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