How cardiovascular risk varies with age, sex, and coronary risk factors: do standard risk scores give an accurate perspective?

The most precise data on trends of cardiovascular risk by age and sex come from national mortality statistics and not from risk factor scoring systems . However, the former are insufficiently specific if based on 5- and 10-yea r age-groups, so that risk by single years of age needs to be interpolated. The one per cent annual cardiovascular mortality (one event per million ho urs) used as an indicator fbr aircrew licensing is reached in England and W ales at age 64 years in men and age 71 years in women. Prospective risk ass essments for 5 or 10 years are inappropriate for licensing aircrew on an an nual basis as they are heavily weighted by later years. Compared with morta lity trends for England and Wales, the age gradient for the Framingham abso lute 10-year risk score was found to be too Bat. The life insurance concept of using age-specific risk and adding or subtracting years, using an appro priate relative or absolute risk factor scoring system, retains its attract ion for aircrew licensing. However, the ideal risk score, incorporating all relevant factors, is yet to be developed.