A team of medical researchers from the Jordi Gol Primary Care Research Institute (IDIAPJGol) and the Primary Care of the ICS Camp de Tarragona has developed a simple tool that allows predicting the risk that each patient has of suffering cardiovascular complications in the next 10 years. This tool collects information from the analysis of data from more than 5,500 people over 60 years of age with type 2 diabetes, who have been followed for a decade, and presents all this information in the form of a family tree. The aim of this instrument is to help identify patients at higher risk in order to prevent these complications.

Type 2 diabetes is a very common disease worldwide, especially among the elderly. In Spain, many patients over 60 years of age with this disease also have other conditions such as high blood pressure or high cholesterol. This puts them at risk of suffering serious cardiovascular diseases such as heart attacks, angina pectoris, strokes (strokes or cerebral infarctions) or even death, since these events are the main cause of mortality in people with type 2 diabetes.

The novelty of this methodology is that it uses a system called the CHAID decision tree (Chi-Square Automatic Interaction Detector). It is like a tree with branches that are divided according to the characteristics of the patients, such as age, blood pressure or fasting cholesterol and blood sugar levels, among other factors. This allows patients to be classified into low, medium or high risk groups, for example:

• A person under 70 years of age has an approximate risk of 13%, but if they have hypertension and very low HDL cholesterol (popularly known as the “good” cholesterol), the risk increases by almost 20%.
• Between the ages of 70-75, if fasting blood sugar is above 175-180 mg/dl, the risk already exceeds 25%.
• In those over 75, the risk is already very high (exceeds 20%), but it increases even more depending on LDL cholesterol levels (popularly, the “bad”), and can reach almost 30%.

This model is particularly useful because it transforms complex clinical and epidemiological data into rules that are easy to apply in the daily consultation of the primary care specialist.

Instead of using calculators that are poorly adapted for the elderly, this system allows a rapid assessment and personalized decisions to be made. For example, monitoring of the patient at highest risk can be intensified in the consultation, medication can be better adjusted, or lifestyle changes can be promoted.

The study, published in the scientific journal BMC Primary Care, provides a simple tool, based on real data from our environment, that can help primary care professionals identify which patients with type 2 diabetes over 60 years of age have a higher cardiovascular risk and, in this way, be able to act in advance to prevent serious complications.

Article reference

Ribas Seguí D, Forcadell M, Vila-Córcoles A, de Diego-Cabanes C, Ochoa-Gondar O, Lujan FM, Gracia ES. Classification rule for ten year MACE Risk in primary care tarragona older adults with type2 diabetes: a CHAID decision-tree analysis. BMC Prim Care. 2025 Apr 25;26(1):129. doi: 10.1186/s12875-025-02826-w. PMID: 40281435; PMCID: PMC12032696.