Effect of blood pressure and total cholesterol measurement on risk prediction using the Systematic COronary Risk Evaluation (SCORE)

Abstract

Background: To compare the reproducibility in total cholesterol (TC), systolic blood pressure (BP), and the resulting Systematic COronary Risk Evaluation (SCORE) obtained by an in-office cardio-preventive screening program (SP) and a subsequent program performed in a clinical trial examination center (EP). Methods: A total of 307 individuals (60.3% female, mean age = 52.8 years) participated. According to TC and BP measurements at the SP and EP, three variables were created: the SCORE SP = single BP reading at the SP, the SCORE EP/BP-first = first BP reading at the EP, and the SCORE EP/BP-mean = mean second/third BP reading at the EP. Differences in TC and BP were analyzed. Associations between age, sex and mean differences between the SCORE SP and the SCORE EP/BP-first (M1) and the SCORE EP/BP-mean (M2) were analyzed using multivariable linear and quantile regression. Results: TC and BP values from the SP were significantly higher than those from the EP. Among individuals with a decreased SCORE value at the EP (compared to the SP), younger age was associated with a higher improvement in risk estimation compared with older age. Female sex was associated with higher risk improvement in the SCORE between the SP and the EP compared with male sex. Associations between both demographics and M1 (M2) achieved statistical significance at the 75.0th (50th) percentile. Conclusions: The reproducibility of results in cardiovascular risk prediction seems to be influenced by the accuracy of BP measurement. It seems that younger individuals and females are more likely to benefit from accuracy compared with older individuals and males.