On Cardiovascular Risk Estimation in Patients With Psoriasis: The REGICOR and SCORE Scales.

Wewould like to congratulate the developers of the recently presented cardiovascular risk calculator1 and to applaud the decision of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (AEDV) to facilitate the clinical practice of dermatologists by including it on their web page. However, we would also like to discuss 2 issues in the interest of making this new service more useful. If our suggestions are not considered feasible or appropriate at this time, they will at least serve to bring to light the range of views held among members of the AEDV. Our first point concerns the main instruments available for assessing cardiovascular risk in Spain: we refer to the Systematic Coronary Risk Evaluation (SCORE) charts and the Girona Heart Registry (REGICOR) scales. The SCORE charts were calibrated for use in the Spanish population and seem to be recommended unanimously by the various scientific associations that have formed the Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention (CEIPC)2; also calibrated and validated, the REGICOR scale is widely used in some of Spain’s autonomous communities.3,4 Comparing risk functions between scales like these is complicated. Aspects usually considered include the rate of drug prescription based on one scoring system or another, agreement between scores, and an instrument’s sensitivity and specificity when used. The manner of making such comparisons, however, lies outside the scope of this letter. We would simply like to note that our literature has seen a bitter debate about which of these 2 instruments is more appropriate for assessing cardiovascular risk in Spain5-9 and that discussants have sometimes overstepped the boundaries of science to include issues that cannot exactly be