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June 19, 2026International Journal of General MedicineOpen Access

Model-Dependent Cardiovascular Risk Stratification in Obese Populations: Multicenter Study in Türkiye

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Population

6,378 obese individuals recruited from seven geographical regions of Türkiye

Design

Cohort

Key result

Cardiovascular risk estimates in obese individuals varied significantly by prediction model, with SCORE2-DM systematically estimating 10-year risk 6.37 percentage points higher than AHA PREVENT.

Authors

NONur Düzen OflasAOAlihan OralİSİhsan Solmaz

Discussion

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Overview

Model discrepancies may alter risk stratification in obese adults; leaves open outcome validation of contemporary equations.

Key Points

  • This study aims to compare cardiovascular risk estimates from various prediction models in obese individuals across Turkey.
  • Multicenter retrospective analysis involving 6,378 obese individuals from seven regions of Türkiye.
  • Cardiovascular risk was estimated using SCORE2, SCORE2-DM, and AHA PREVENT models; statistical analyses included Kruskal–Wallis test and Spearman correlation.
  • Multivariable linear regression was used to evaluate regional differences after adjusting for comorbidities and demographics.
  • Substantial regional differences in smoking prevalence and comorbidities were found across regions.
  • SCORE2 identified the highest median risk in the Mediterranean region, while SCORE-DM showed similar estimates across regions; PREVENT highlighted regional disparities as well.
  • SCORE2 and PREVENT had strong agreement in ranking patients but modest agreement in categorical risk classification, with significant regional differences remaining after adjustments.

Study Design

Type

Observational (n=6,378)

Multicenter

Yes

Structured PICO

P
Population
6,378 obese adults (BMI ≥30 kg/m2) from seven geographical regions of Türkiye, evaluated retrospectively to compare 10-year cardiovascular risk estimates derived from SCORE2, SCORE2-DM, and AHA PREVENT models.
E
Exposure
Cardiovascular risk estimation using SCORE2, SCORE2-DM, and AHA PREVENT equations
O
Outcome
Inter-model agreement and confounder-adjusted regional differences in 10-year cardiovascular risk estimates

Main Result

Mean Difference: 6.37 (95% CI 5.7–7.04)

Contemporary cardiovascular risk models (SCORE2, SCORE2-DM, AHA PREVENT) show substantial divergence in absolute risk estimates and categorical classifications when applied to an obese population in Türkiye.

Limitations

  • Analysis is based on model-derived estimates rather than observed cardiovascular outcomes
  • Retrospective design
  • Potential unmeasured confounders such as healthcare access, socioeconomic disparities, and dietary patterns
  • Based on model-derived estimates rather than observed cardiovascular outcomes

Cite This Study

Oflas et al. (2026) conducted an observational in Obesity (n=6,378). SCORE2, SCORE2-DM, and AHA PREVENT models vs. Inter-model comparison was evaluated on Inter-model agreement between SCORE2-DM and PREVENT for 10-year cardiovascular risk (mean difference 6.37%, 95% CI 5.70-7.04). Cardiovascular risk estimates in obese individuals varied significantly by prediction model, with SCORE2-DM systematically estimating 10-year risk 6.37 percentage points higher than AHA PREVENT.

synapsesocial.com/papers/6a35982fdd3be7785e70ed28https://doi.org/10.2147/ijgm.s602816
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Conducting a Screening Study Using the SCORE Cardiovascular Disease Risk Assessment Model and Discussion of the SCORE Model in Light of the Results2025
  2. 2Independent external validation and head-to-head comparison of guideline-recommended CVD risk prediction models.2026
  3. 3Independent external validation and head-to-head comparison of guideline-recommended CVD risk prediction models2026
  4. 4Predicting cardiovascular risk under intervention: Development and internal validation of the CHARIOT Model in 19 million adults2025 · 1 citations
  5. 5Comparison of Globorisk, SCORE2, and PREVENT in the Stratification of Cardiovascular Risk and its Relationship with End‐Organ Damage Among Adults With Arterial Hypertension2025 · 2 citations