在初级保健中使用的一般心血管风险概况:弗雷明汉心脏研究
Ralph B D'Agostino1, Ramachandran S Vasan, Michael J Pencina
1Boston University, Department of Mathematics and Statistics, 111 Cummington St, Boston, MA 02215, USA.
Circulation
|January 24, 2008
概括
一个新的性别特定算法预测了整体动脉样硬化心血管疾病 (CVD) 风险和个体事件风险. 这种工具有助于量化风险,并指导预防性护理,以改善心血管健康.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 流行病学 流行病学
背景情况:
- 目前的实践在不同的动脉样硬化心血管疾病 (CVD) 事件中使用了独立的风险算法.
- 需要采用统一的方法来评估整体心血管疾病风险及其组成部分.
研究的目的:
- 开发和验证一个单一的,特定于性别的多变量风险算法,用于预测一般心血管疾病风险.
- 评估算法的预测个人心血管疾病事件的能力,包括冠心病,中风,外周动脉疾病和心力衰竭.
主要方法:
- 考克斯对8491名弗雷明汉研究参与者的比例风险回归分析.
- 包括传统的风险因素:年龄,胆固醇,血压,高血压治疗,吸烟和糖尿病状况.
- 验证特定于性别的算法,用于预测12年的一般和特定心血管疾病事件.
主要成果:
- 开发的"一般心血管疾病"算法表现出良好的预测性能 (C统计:男性0.763,女性0.793).
- 所有评估的传统风险因素都显著预测了心血管疾病风险 (P<0.0001).
- 通过简单的调整,可以对单个CVD组件的风险进行估计.
结论:
- 一个特定于性别的多变量算法有效地评估了一般心血管疾病风险和个别事件风险.
- 该工具可以量化绝对CVD事件率,以指导预防策略.
- 该算法为临床实践中的风险评估提供了一种方便的方法.
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