Related Experiment Video
Updated: Sep 13, 2025
Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
Agreement between Framingham, Pooled Cohort Equations, and Globorisk-LAC in the Estimation of Cardiovascular Risk in
Leonardo Ferreira Fontenelle1, Thiago Dias Sarti1, Gabriela Callo Quinte2
1Universidade Federal do Espírito Santo (UFES) Departamento de Medicina Social, Vitoria, ES - Brasil.
Background:
The Framingham risk score and Pooled Cohort Equations (PCE) have never been recalibrated for the Brazilian population. In contrast, the Globorisk-LAC score was recently derived using a methodology analogous to the PCE and has been recalibrated for Latin American countries.
Objectives:
To describe the agreement between the Framingham, PCE, and Globorisk-LAC scores in estimating the 10-year cardiovascular risk in the Brazilian population.
Methods:
This cross-sectional study used the three scores to estimate cardiovascular risk in participants aged 40 to 74 years without a history of cardiovascular disease based on data from the 2013 National Health Survey (PNS). The agreement was estimated as (i) the percentage of participants in which the risk estimated by one score was between 0.80 and 1.25 times the risk estimated by another score and (ii) based on the Gwet's agreement coefficient (AC1) according to risk categories (low, intermediate, and high).
Results:
A total of 4,416 participants were included from 8,952 participants from the PNS with a laboratory component. The median (interquartile range) of the estimated 10-year cardiovascular risk was 9.2% (5.1 to 17.8) according to the Framingham, 3.6% (1.7 to 8.2) according to the PCE, and 4.7% (2.8 to 8.1) according to the Globorisk-LAC. The risk estimated using the Framingham agreed with the Globorisk-LAC and PCE in 6.4% and 1.8% of the cases, respectively, whereas the PCE and Globorisk-LAC agreed in 34.7% of the cases. When considering the risk stratification, the respective AC1 values were 0.454, 0.489, and 0.874.
Conclusions:
The three cardiovascular risk scores showed low levels of agreement with each other. The reasons for this disagreement suggests that Globorisk-LAC is a strong candidate to replace the Framingham in the Brazilian guidelines for dyslipidemia.
Related Concept Videos
01:12Relative Risk
01:23Assessment of blood pressure in brachial artery(two-step method)
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:29Bias in Epidemiological Studies
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...