Differences between SCORE, Framingham Risk Score, and Estimated Pulse Wave Velocity-Based
Vascular Age Calculation Methods Based on Data from the Three Generations Health Program
in Hungary
Early vascular ageing contributes to cardiovascular (CV) morbidity and mortality.
There are different possibilities to calculate vascular age including methods based
on CV risk scores, but different methods might identify different subjects with early
vascular ageing. We aimed to compare SCORE and Framingham Risk Score (FRS)-based vascular
age calculation methods on subjects that were involved in a national screening program
in Hungary. We also aimed to compare the distribution of subjects identified with
early vascular ageing based on estimated pulse wave velocity (ePWV). The Three Generations
for Health program focuses on the development of primary health care in Hungary. One
of the key elements of the program is the identification of risk factors of CV diseases.
Vascular ages based on the SCORE and FRS were calculated based on previous publications
and were compared with chronological age and with each other in the total population
and in patients with hypertension or diabetes. ePWV was calculated based on a method
published previously. Supernormal, normal, and early vascular ageing were defined
as <10%, 10–90%, and >90% ePWV values for the participants. In total, 99,231 subjects
were involved in the study, and among them, 49,191 patients had hypertension (HT)
and 15,921 patients had diabetes (DM). The chronological age of the total population
was 54.0 (48.0–60.0) years, while the SCORE and FRS vascular ages were 59.0 (51.0–66.0)
and 64.0 (51–80) years, respectively. In the HT patients, the chronological, SCORE,
and FRS vascular ages were 57.0 (51.0–62.0), 63.0 (56.0–68.0), and 79.0 (64.0–80.0)
years, respectively. In the DM patients, the chronological, SCORE, and FRS vascular
ages were 58.0 (52.0–62.0), 63.0 (56.0–68.0), and 80.0 (76.0–80.0) years, respectively.
Based on ePWV, the FRS identified patients with an elevated vascular age with high
sensitivity (97.3%), while in the case of the SCORE, the sensitivity was much lower
(13.3%). In conclusion, different vascular age calculation methods can provide different
vascular age results in a population-based cohort. The importance of this finding
for the implementation in CV preventive strategies requires further studies.