SCORE2-OP working group and ESC Cardiovascular risk collaboration, et al. - Researchers aimed at deriving and validating the SCORE2-Older Persons (SCORE2-OP) risk model for estimating 5- and 10-year risk of cardiovascular disease (CVD) in individuals aged over 70 years in four geographical risk regions. The gender-specific competing risk-adjusted models were derived for ascertaining CVD risk (CVD mortality, myocardial infarction, or stroke) in individuals aged over 65 without pre existing atherosclerotic CVD from the Cohort of Norway (28,503 individuals, 10,089 CVD events). Age, smoking status, diabetes, systolic blood pressure, and total- and high-density lipoprotein cholesterol were included in the models. Based on country-specific CVD mortality rates, four geographical risk regions were defined. Satisfactory regional calibration of expected-vs.-observed risks were observed. For given risk factor profiles, substantial variation was observed across the four risk regions in the estimated 10-year CVD event risk. The derived competing risk-adjusted SCORE2-OP models can be employed for communicating the risk of CVD and potential benefit from risk factor treatment and may aid in shared decision-making between clinicians and patients in CVD risk management in older persons.