The SCORE model in the POWER study: an attempt to focus the limited resources for prevention on patients with greatest need

As the emergence of cardiovascular disease (CVD) is linked to modifiable lifestyle and physiological factors, it is increasingly important to concentrate on preventative strategies. For preventative measures to be beneficial it is necessary to clearly identify patients at risk - given that multiple risk factors often cluster this requires the assessment of total cardiovascular (CV) risk. Total CV risk can be estimated in different ways; in the guidelines on the management of arterial hypertension by a Joint Task Force of the European Society of Hypertension and the European Society of Cardiology a categorical approach was recommended. A model based on results from the US Framingham study has been available for many years. Systemic COronary Risk Evaluation (SCORE) is a recently developed total CV risk assessment model, based on approximately 3 million person-years of observation, which estimates fatal CVD events over a 10-year period, incorporating both coronary heart disease and cerebrovascular disease. The SCORE model aids clinicians in their decision on how to engage in preventative measures and how to adjust the intensity of their preventative efforts in accordance with the total CV risk of the patient. The SCORE model has been incorporated into the Physicians Observational Work on Patient Education According to their Vascular Risk (POWER) study. This study, with an estimated sample size of 60000 patients, will determine if SCORE can act as a suitable tool to aid the lowering of CV risk.