Clinical Resources

SCORE2-OP Calculator

ESC 2021 — 10-Year CVD Risk for Older Persons (age 70+)

SCORE2-OP estimates 10-year risk of fatal and non-fatal cardiovascular events in persons aged 70 and older. It uses a competing-risk framework that accounts for the substantial non-CVD mortality in this age group. Risk thresholds are calibrated by European CVD risk region.

Range: 70-100
Non-HDL = Total cholesterol minus HDL. Use helper below if needed. 1 mmol/L = 38.67 mg/dL

Non-HDL Cholesterol Helper

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ESC 2021 Treatment Thresholds (Age 70+)

  • Age 70-74: Low-moderate <7.5% | High 7.5-15% | Very high ≥15%
  • Age 75+: Low-moderate <15% | High 15-25% | Very high ≥25%

Key Considerations in Older Persons

  • SCORE2-OP incorporates competing risk of non-CV death, which increases substantially with age.
  • Frailty, comorbidity burden, and patient preferences should guide shared decision-making beyond the numerical risk estimate.
  • Diabetes and blood pressure treatment are risk modifiers that shift estimated risk upward.
  • Non-HDL cholesterol (rather than LDL) is the primary lipid input, reflecting atherogenic lipoprotein burden.

References

  1. SCORE2-OP Working Group & ESC Cardiovascular Risk Collaboration. SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. Eur Heart J. 2021;42(25):2455-2467.
  2. Visseren FLJ, Mach F, Smulders R, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227-3337.