The Framingham prediction rule is not valid in a European population of treated hypertensive patients

Sylvie Bastuji-Garin, Anne Deverly, Dominique Moyse, Alain Castaigne, Giuseppe Mancia, Peter W. De Leeuw, Luis M. Ruilope, Talma Rosenthal, Gilles Chatellier

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Background: Stratification of population groups according to cardiovascular risk level is recommended for primary prevention. Objective: To assess whether the Framingham models could accurately predict the absolute risk of coronary heart disease (CHD) and stroke in a large cohort of middle-aged European patients with hypertension, and rank individual patients according to actual risk. Design: A prospective cohort study comparing the actual risk with that predicted by either the Framingham equations or models derived from the INSIGHT study. Patients and setting: From the INSIGHT prospective trial, conducted in eight countries of Western Europe and Israel, we selected 4407 European patients younger than 75 years without previous cardiovascular events. Interventions: None. Main outcome measures: Major cardiovascular events. Results: In this population (45% men, mean age 64.1 years), 124 (2.8%) patients had CHD and 96 (2.2%) had strokes after a median follow-up of 3.7 years. Overestimation of absolute CHD risk by the Framingham equation was observed in all countries (from 2% in the UK to 7% in France), whereas predicted risk of stroke was close to the actual risk. However, patients in the highest risk quintile within each country had a threefold greater risk of a cardiovascular event than those in the lowest quintile. Conclusions: The Framingham models should not be used to predict absolute CHD risk in the European population as a whole. However, these models may be used within each country, provided that cut-off points defining high-risk patients have been determined within each country.

Original languageEnglish
Pages (from-to)1973-1980
Number of pages8
JournalJournal of Hypertension
Volume20
Issue number10
DOIs
Publication statusPublished - Oct 1 2002

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Population
Coronary Disease
Stroke
Israel
Primary Prevention
Population Groups
France
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies
Hypertension

Keywords

  • Coronary heart disease
  • European cohort
  • Risk factors
  • Risk prediction
  • Stroke

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine

Cite this

Bastuji-Garin, S., Deverly, A., Moyse, D., Castaigne, A., Mancia, G., De Leeuw, P. W., ... Chatellier, G. (2002). The Framingham prediction rule is not valid in a European population of treated hypertensive patients. Journal of Hypertension, 20(10), 1973-1980. https://doi.org/10.1097/00004872-200210000-00016

The Framingham prediction rule is not valid in a European population of treated hypertensive patients. / Bastuji-Garin, Sylvie; Deverly, Anne; Moyse, Dominique; Castaigne, Alain; Mancia, Giuseppe; De Leeuw, Peter W.; Ruilope, Luis M.; Rosenthal, Talma; Chatellier, Gilles.

In: Journal of Hypertension, Vol. 20, No. 10, 01.10.2002, p. 1973-1980.

Research output: Contribution to journalArticle

Bastuji-Garin, S, Deverly, A, Moyse, D, Castaigne, A, Mancia, G, De Leeuw, PW, Ruilope, LM, Rosenthal, T & Chatellier, G 2002, 'The Framingham prediction rule is not valid in a European population of treated hypertensive patients', Journal of Hypertension, vol. 20, no. 10, pp. 1973-1980. https://doi.org/10.1097/00004872-200210000-00016
Bastuji-Garin, Sylvie ; Deverly, Anne ; Moyse, Dominique ; Castaigne, Alain ; Mancia, Giuseppe ; De Leeuw, Peter W. ; Ruilope, Luis M. ; Rosenthal, Talma ; Chatellier, Gilles. / The Framingham prediction rule is not valid in a European population of treated hypertensive patients. In: Journal of Hypertension. 2002 ; Vol. 20, No. 10. pp. 1973-1980.
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