Pocock et al developed a score for predicting the risk of death from cardiovascular disease in adults with an elevated blood pressure. It can help a physician determine an individual's need for antihypertensive treatment and other interventions to reduce the risk. The authors are from the INDANA project in Europe which maintains a database of individual data for patients enrolled in antihypertensive intervention trials.
Patients: adults >= 35 years of age
Parameters:
(1) gender
(2) age
(3) cigarette smoking
(4) systolic blood pressure
(5) total cholesterol concentration
(6) height
(7) creatinine concentration
(8) history of myocardial infarction
(9) history of stroke
(10) left ventricular hypertrophy
(11) diabetes mellitus
|
Parameter |
Finding |
Points Female |
Points Male |
|
gender |
female or male |
0 |
12 |
|
age in years |
35 – 39 |
0 |
0 |
|
|
40 – 44 |
5 |
4 |
|
|
45 – 49 |
9 |
7 |
|
|
50 – 54 |
14 |
11 |
|
|
55 – 59 |
18 |
14 |
|
|
60 – 64 |
23 |
18 |
|
|
65 – 69 |
27 |
22 |
|
|
70 -74 |
32 |
25 |
|
cigarette smoker |
no |
0 |
0 |
|
|
yes and 35 – 39 years old |
13 |
9 |
|
|
yes and 40 – 44 years old |
12 |
7 |
|
|
yes and 45 – 49 years old |
11 |
7 |
|
|
yes and 50 – 54 years old |
10 |
6 |
|
|
yes and 55 – 59 years old |
10 |
6 |
|
|
yes and 60 – 64 years old |
9 |
5 |
|
|
yes and 65 – 69 years old |
9 |
4 |
|
|
yes and 70 -74 years old |
8 |
4 |
|
systolic blood pressure |
110 – 119 mm Hg |
0 |
0 |
|
|
120 –129 mm Hg |
1 |
1 |
|
|
130 – 139 mm Hg |
2 |
2 |
|
|
140 – 149 mm Hg |
3 |
3 |
|
|
150 – 159 mm Hg |
4 |
4 |
|
|
160 – 169 mm Hg |
5 |
5 |
|
|
170 – 179 mm Hg |
6 |
6 |
|
|
180 – 189 mm Hg |
8 |
8 |
|
|
190 – 199 mm Hg |
9 |
9 |
|
|
200 – 209 mm Hg |
10 |
10 |
|
|
>= 210 mm Hg |
11 |
11 |
|
total cholesterol concentration |
< 5 mmol/L |
0 |
0 |
|
|
5.0 – 5.9 mmol/L |
0 |
2 |
|
|
1 |
4 |
|
|
|
7.0 – 7.9 mmol/L |
1 |
5 |
|
|
8.0 – 8.9 mmol/L |
2 |
7 |
|
|
>= 9.0 mmol/L |
2 |
9 |
|
height in meters |
< 1.45 meters |
6 |
6 |
|
|
1.45 – 1.54 meters |
4 |
6 |
|
|
1.55 – 1.59 meters |
3 |
6 |
|
|
1.60 – 1.64 meters |
3 |
4 |
|
|
1.65 – 1.69 meters |
2 |
4 |
|
|
1.70 – 1.74 meters |
2 |
3 |
|
|
1.75 – 1.79 meters |
0 |
3 |
|
|
1.80 – 1.89 meters |
0 |
2 |
|
|
>= 1.90 meters |
0 |
0 |
|
creatinine concentration |
< 70 µmol/L |
0 |
0 |
|
|
70 – 79 µmol/L |
1 |
1 |
|
|
80 – 89 µmol/L |
1 |
1 |
|
|
90 – 99 µmol/L |
2 |
2 |
|
|
100 – 109 µmol/L |
2 |
2 |
|
|
110 – 119 µmol/L |
3 |
3 |
|
|
120 – 129 µmol/L |
3 |
3 |
|
|
>= 130 µmol/L |
4 |
4 |
|
history of MI |
no |
0 |
0 |
|
|
yes |
8 |
8 |
|
history of stroke |
no |
0 |
0 |
|
|
yes |
8 |
8 |
|
left ventricular hypertrophy |
no |
0 |
0 |
|
|
yes |
3 |
3 |
|
diabetes mellitus |
no |
0 |
0 |
|
|
yes |
9 |
2 |
from Figure 1, page 77
risk score =
= SUM(points for all of the risk factors)
Interpretation:
• minimum score: 0
• maximum score: 91 female, 92 male
• The higher the score, the greater the risk of cardiovascular death.
|
Risk Score |
Percent Dying from Cardiovascular Disease in 5 Years |
|
0 |
0.04% |
|
5 |
0.07% |
|
10 |
0.11% |
|
15 |
0.19% |
|
20 |
0.31% |
|
25 |
0.51% |
|
30 |
0.84% |
|
35 |
1.4% |
|
40 |
2.3% |
|
45 |
3.7% |
|
50 |
6.1% |
|
55 |
9.8% |
|
60 |
15.6% |
|
65 |
24.5% |
|
70 |
37.0% |
from Figure 2, page 78
If this is analyzed in JMP, the following approximating equation is derived:
risk of death in 5 years from cardiovascular disease as a percent =
= (0.000006 * ((score)^4)) - (0.0005 * ((score)^3)) + (0.0150098 * ((score)^2)) – (0.137002 * (score)) + 0.2287023
An alternative equation is:
risk of death in 5 years from cardiovascular disease as a percent =
= EXP((0.098145*(score)) - 3.1445)
Purpose: To estimate the risk of mortality from cardiovascular disease in 5 years using the risk score of Pocock et al.
Specialty: Cardiology
Objective: risk factors, severity, prognosis, stage, complications, selection
ICD-10: I11,
