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Published on: September 26, 2018

Framingham risk score for prediction of cardiovascular diseases: a population-based study from southern Europe

Luis M Artigao-Rodenas1, Julio A Carbayo-Herencia, Juan A Divisón-Garrote

  • 1Community Medicine, Zone 3 Primary Health Care Centre, Albacete, Spain.

Plos One
|September 17, 2013
PubMed

Insights

This study validated a new cardiovascular disease risk function in a Spanish population, finding it effective for primary prevention. The model showed good discrimination and calibration, supporting its use in diverse populations.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The optimal risk function for cardiovascular disease (CVD) primary prevention remains debated.
  • The Framingham Study proposed a novel algorithm using cholesterol, blood pressure, diabetes, smoking, overall CVD prediction, and vascular age.
  • Validation of this new risk function in non-Anglo-Saxon populations is necessary.

Purpose of the Study:

  • To evaluate the validity of the Framingham Study's new risk function.
  • To assess its performance in a general, non-Anglo-Saxon population cohort over a 10-year period.

Main Methods:

  • A cohort of 959 individuals (aged 30-74) from Albacete, Spain, was studied in two cycles (1992-94 and 2004-06).
  • Data for the risk function were collected in the first cycle; CVD events were recorded during follow-up.
  • Discrimination was assessed using ROC curves, and model calibration was performed with Hosmer-Lemeshow tests.

Main Results:

  • Mean CVD risks were 11.3% for women and 19.7% for men, with ROC AUCs of 0.789 and 0.780, respectively (P<0.001).
  • CVD events predominantly occurred in the highest risk tertiles, demonstrating good predictive value.
  • The model showed good specificity in women (85.6%) and sensitivity in men (79.1%) for high-risk individuals, though it overestimated risk in older women and middle-aged men.

Conclusions:

  • The findings support the Framingham risk function's 'reclassification' proposal.
  • The model demonstrated adequate discrimination and calibration in this southern European general population sample.
  • This study suggests the utility of the revised Framingham risk function across diverse ethnic groups.
Abstract

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