The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications.

INTRODUCTION AND OBJECTIVES: To determine which cardiovascular risk function is best for classifying high-risk individuals on statins. METHODS: Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk >or=10%), Framingham-Wilson (10-year risk >or=20%) and SCORE (10-year risk >or=5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol. RESULTS: Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P< .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P< .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years (OR=0.51; 95% CI, 0.32-0.81). CONCLUSIONS: The Framingham-REGICOR function was better at classifying high-risk patients on statins than the Framingham-Wilson or SCORE functions. Statin use was associated with hypercholesterolemia and hypertension and inversely with age in patients <65 years.

La función calibrada REGICOR mejora la clasificación de los pacientes de alto riesgo tratados con estatinas respecto a Framingham y SCORE en la población española / The REGICOR-calibrated function provides a better classification of high-risk patients on statin treatment in the Spanish population than the Framingham or SCORE classifications

Introducción y objetivos. Estudiar qué función de riesgo cardiovascular clasifica mejor a los pacientes con riesgo cardiovascular alto que toman estatinas. Métodos. Estudio descriptivo transversal que incluye a 804 pacientes de 35-74 años, seleccionados aleatoriamente. Se estudiaron las variables tratamiento con estatinas, riesgo cardiovascular alto con las ecuaciones de Framingham-REGICOR (≥ 10% a 10 años), Framingham-Wilson (≥ 20% a 10 años) y SCORE (≥ 5% a 10 años), edad, sexo, colesterol total, colesterol de las lipoproteínas de alta densidad (cHDL) y factores de riesgo cardiovascular. Resultados. Tomaban estatinas 83 (10,3%) pacientes. La prevalencia de hipercolesterolemia fue del 25,6%. Comparando a los pacientes de bajo y medio riesgo con los de alto riesgo, SCORE sólo halló diferencias significativas en el cHDL más bajo (diferencia: 5,1 mg/dl; p < 0,001), mientras que Framingham-REGICOR y Framingham-Wilson mostraron (p < 0,001) mayor prevalencia de hipercolesterolemia (el 41 y el 37,8% respectivamente), colesterol total más elevado (diferencia, 15 y 12,5 mg/dl respectivamente) y cHDL más bajo (diferencia, 11,9 y 12 mg/dl respectivamente). Tomaba estatinas el 16% de pacientes de alto riesgo con Framingham-REGICOR (odds ratio [OR] = 1,81; intervalo de confianza [IC] del 95%, 1,01-3,27), el 13,4% con Framingham-Wilson (OR = 1,47; IC del 95%, 0,87-2,47) y el 10,6% con SCORE (OR = 1,09; IC del 95%, 0,50-2,37). Se asociaron significativamente al uso de estatinas la hipertensión (OR = 1,89; IC del 95%, 1,20-2,99) y la hipercolesterolemia (OR = 11,01; IC del 95%, 6,55-18,53), con una relación inversa con la edad < 65 años (OR = 0,51; IC del 95%, 0,32-0,81). Conclusiones. La función Framingham-REGICOR clasifica mejor que Framingham-Wilson y SCORE a los pacientes de riesgo alto que reciben tratamiento con estatinas. La prescripción se asoció al diagnóstico de hipercolesterolemia y HTA y fue menor en pacientes < 65 años (AU)

Introduction and objectives. To determine which cardiovascular risk function is best for classifying high-risk individuals on statins. Methods. Descriptive cross-sectional study of 804 randomly selected patients aged 35-74 years. Variables studied included statin treatment, high cardiovascular risk according to Framingham-REGICOR (10-year risk ≥10%), Framingham-Wilson (10-year risk ≥20%) and SCORE (10-year risk ≥5%) functions, age, sex, cardiovascular risk factors, and total and high-density lipoprotein (HDL) cholesterol. Results. Overall, 83 patients (10.3%) were taking statins. The prevalence of hypercholesterolemia was 25.6%. When high-risk patients were compared with low- and medium-risk patients, the SCORE function only found a significant difference in HDL-cholesterol level (difference, 5.1 mg/dl; P < .001), whereas the Framingham-REGICOR and Framingham-Wilson functions showed that hypercholesterolemia was more prevalent (at 41% and 37.8%, respectively), the total cholesterol level was higher (difference, 15 mg/dl and 12.5 mg/dl, respectively), and the HDL-cholesterol level was lower (difference, 11.9 mg/ dl and 12 mg/dl, respectively; all P < .001). The percentage of patients on statins classified as high-risk by each function was 16% for Framingham-REGICOR (odds ratio [OR]=1.81; 95% confidence interval [CI], 1.01-3.27), 13.4% for Framingham-Wilson (OR=1.47; 95% CI, 0.87-2.47) and 10.6% for SCORE (OR=1.09; 95% CI, 0.50-2.37). Statin use was also significantly associated with hypertension (OR=1.89; 95% CI, 1.20-2.99) and hypercholesterolemia (OR=11.01; 95% CI, 6.55-18.53), and inversely associated with age in patients <65 years or 95 ci 0 32-0 81 conclusions the framingham-regicor function was better at classifying high-risk patients on statins than framingham-wilson score functions statin use associated with hypercholesterolemia and hypertension inversely age in <65 years (AU)