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

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...

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Main Authors: Nelson, M., Ramsay, E., Ryan, P., Willson, K., Tonkin, A., Wing, L., Simons, L., Reid, Christopher
Format: Journal Article
Published: 2012
Online Access:http://hdl.handle.net/20.500.11937/31264
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author Nelson, M.
Ramsay, E.
Ryan, P.
Willson, K.
Tonkin, A.
Wing, L.
Simons, L.
Reid, Christopher
author_facet Nelson, M.
Ramsay, E.
Ryan, P.
Willson, K.
Tonkin, A.
Wing, L.
Simons, L.
Reid, Christopher
author_sort Nelson, M.
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-312642017-09-13T15:12:27Z A score for the prediction of cardiovascular events in the hypertensive aged Nelson, M. Ramsay, E. Ryan, P. Willson, K. Tonkin, A. Wing, L. Simons, L. Reid, Christopher 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. 2012 Journal Article http://hdl.handle.net/20.500.11937/31264 10.1038/ajh.2011.192 unknown
spellingShingle Nelson, M.
Ramsay, E.
Ryan, P.
Willson, K.
Tonkin, A.
Wing, L.
Simons, L.
Reid, Christopher
A score for the prediction of cardiovascular events in the hypertensive aged
title A score for the prediction of cardiovascular events in the hypertensive aged
title_full A score for the prediction of cardiovascular events in the hypertensive aged
title_fullStr A score for the prediction of cardiovascular events in the hypertensive aged
title_full_unstemmed A score for the prediction of cardiovascular events in the hypertensive aged
title_short A score for the prediction of cardiovascular events in the hypertensive aged
title_sort score for the prediction of cardiovascular events in the hypertensive aged
url http://hdl.handle.net/20.500.11937/31264