A Point System Table to Estimate the Risk of Cardiovascular Events in Patients with Hypertension and Left Ventricular Hypertrophy: The LIFE Study

We aimed to assess some readily available patient characteristics such as urinary albumin excretion as predictors of a primary composite event of myocardial infarction, cerebral stroke, and cardiovascular death among patients with hypertension and left ventricular hypertrophy, and develop risk algorithms for the outcomes. A “Cox proportional hazards” model identified the baseline variables that significantly affected the occurrence of the composite endpoint in 9193 elderly hypertensive patients with left ventricular hypertrophy in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. We developed a risk point table, which assigned points to various risk factors, including the important age-gender interaction term, by adapting the point system algorithm developed from Framingham data. The Cox model identified 12 predictors of risk for the endpoint. Points for age were calculated separately for females and males due to the age-gender interaction. The risk estimates that were defined by total points were compared to those that were determined by the Cox model, and the weighted κ value for the agreement was 0.89. Thus, several patient characteristics predicted cardiovascular events in patients with hypertension and left ventricular hypertrophy, with age, gender, and urinary albumin excretion being the most important. The risk point table is an intuitive method to compare the relative contribution of the cardiovascular risk predictors and explain complicated statistical models such as the interaction term to patients and their physicians.

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