A Proposed Scoring Scheme for Assessing Coronary Risk in Turkish Adults

Since Turkish adults possess distinctive features in risk profile, the need for a suitable scoring system to assess the individual coronary risk is apparent. With this purpose, a scoring scheme was designed which was inspired by the PROCAM and the Framingham scores and was tested on the cohort of the Turkish Adult Risk Factor Study. The baseline data of the cohort of the 1997/98 survey, aged 30-74 years, comprising 1129 men and 1139 women were utilized as was the number of coronary events in the subsequent 3 years. Our scheme included 9 risk variables: age, systolic blood pressure, cigarette smoking, presence of diabetes, levels of LDL-cholesterol, HDL-cholesterol, triglycerides, waist circumference and physical activity grade. Each participant in the database was scored for principal risk factors according to PROCAM in men, and to the Framingham risk score in women. Individuals of both genders were also scored by the newly designed system. Correlation between individual point counts among the two scoring systems was as high as r =0. 98 in men and 0. 95 among women. When the cohort was divided into quintiles according to risk scores, the percent development of coronary heart disease (CHD) events and that by the devised scheme were very close in both genders. This disclosed that the new score was a valid scheme for CHD risk. Mean risk points among apparently healthy men was 15.2 ±6.5, in men with CHD 22.8±5.6. Respective points in apparently healthy women was 15.6±9.7 (Framingham score 4.4±5.8), in women with CHD 26.4±5.4 (Framingham points 10.7±2.7). Scores were finally selected in the database which reflected a ?20% coronary event risk in the subsequent 10-year period. These turned out to be ?23 points in men, and ?26 points in women. It was thereby estimated that 20.5% of Turkey's population aged 30-74 years (roughly 4.5 million persons) was comprised in the coronary high-risk category. This single scoring scheme is found suitable to rank the individual CHD risk both in Turkish men and women with a high reliability. The score ranges suited to estimate the high and intermediate risk may be used as of now. With the aid of future data, these ranges may slightly be modified and further refined.