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 language | English |
|---|---|
| Pages (from-to) | 1973-1980 |
| Number of pages | 8 |
| Journal | Journal of Hypertension |
| Volume | 20 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 1 2002 |
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Keywords
- Coronary heart disease
- European cohort
- Risk factors
- Risk prediction
- Stroke
ASJC Scopus subject areas
- Endocrinology
- Internal Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - The Framingham prediction rule is not valid in a European population of treated hypertensive patients
AU - Bastuji-Garin, Sylvie
AU - Deverly, Anne
AU - Moyse, Dominique
AU - Castaigne, Alain
AU - Mancia, Giuseppe
AU - De Leeuw, Peter W.
AU - Ruilope, Luis M.
AU - Rosenthal, Talma
AU - Chatellier, Gilles
PY - 2002/10/1
Y1 - 2002/10/1
N2 - 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.
AB - 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.
KW - Coronary heart disease
KW - European cohort
KW - Risk factors
KW - Risk prediction
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=0036806860&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036806860&partnerID=8YFLogxK
U2 - 10.1097/00004872-200210000-00016
DO - 10.1097/00004872-200210000-00016
M3 - Article
VL - 20
SP - 1973
EP - 1980
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 10
ER -