Mortality from cardiovascular disease- Is Norway still a high risk country and do we all need statins?

Population studies have demonstrated a striking effect of the combination of several risk factors, such as cholesterol, blood pressure and smoking, on the risk of cardiovascular disease (CVD). A measure of the combined effect, which can be used for scient ific purposes and clinical practice is important. In Norway a risk score for myocardial infarction (WSC) has been developed and used in large cardiovascular surveys since 1972. This score was based on relative risk. The first function for absolute risk wa s based on the Framingham study. The recent European guidelines for the prevention of CVD in clinical practice recommend the calculation of ten-year risk of cardiovascular death according to the SCORE model based on European cohorts. The aim of the proje ct is to evaluate the SCORE model for Norway. Comparisons with the WSC score and Framingham risk functions will be made by application of the functions on data sets from population surveys conducted in different parts of Norway from 1974-2004 (appr 500 00 0 persons). We will develop a new risk function and compare it with the established ones. We will evaluate the predictive value based on data linked to the Norwegian Cause of Death Register. In this project we will continue the collaboration with the Euro pean SCORE group. The project aims at investigating a combination of interesting medical and statistical questions, related to the importance and consequences of the use of risk functions in Norway. The risk functions are used as a basis to prescribe pre ventive medical treatment. Each year approximately 2.6 billon NOK are used on drug based prevention of CVD, whereof the government cover the main expenses. It will thus have major economical consequences if our results suggest that the SCORE function is n ot well suited for the Norwegian population. The projections of risk from current age to age 60 may also have great consequences for number of people qualifying for preventive medical treatment.