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Background Guidelines for the prevention of coronary heart disease (CHD) recommend use of Framingham-based risk scores that were developed in white middle-aged populations. It remains unclear whether and how CHD risk prediction might be improved among older adults. We aimed to compare the prognostic performance of the Framingham risk score (FRS), directly and after recalibration, with refit functions derived from the present cohort, as well as to assess the utility of adding other routinely available risk parameters to FRS. Results During 8-year follow-up, 351 participants experienced CHD events.

The FRS poorly discriminated between persons who experienced CHD events vs. Not (C-index: 0.577 in women; 0.583 in men) and underestimated absolute risk prediction by 51% in women and 8% in men. Recalibration of the FRS improved absolute risk prediction, particulary for women. For both genders, refitting these functions substantially improved absolute risk prediction, with similar discrimination to the FRS. Results did not differ between whites and blacks. The addition of lifestyle variables, waist circumference and creatinine did not improve risk prediction beyond risk factors of the FRS.

ATP III Guidelines At-A-Glance. CHD risk (see Framingham tables). Estimate of 10-Year Risk for Men (Framingham Point Scores) Age Points 20-34 -9 35-39 -4. This Framingham risk score calculator estimates the 10-year coronary heart disease risk of any person based on certain criteria like gender, age, cholesterol and. Raccolta Foto Windows Vista Aggiornamento Java there. To determine the cardiovascular risk, the Framingham score was calculated. CARDIOVASCULAR RISK ASSESSMENT ACCORDING TO THE FRAMINGHAM SCORE AND ABDOMINAL OBESITY IN INDIVIDUALS SEEN BY A CLINICAL SCHOOL OF. Height measurements to calculate body mass index (BMI). Observed 10-year fatal CHD (myocardial infarction or sudden death) and fatal CVD (myocardial infarction, sudden death, stroke, or peripheral vascular disease) event rates were derived from Kaplan-Meier survival curves. Framingham, SCORE, and DECODE 10-year risk scores were calculated for fatal CVD and fatal CHD.

Citation: Rodondi N, Locatelli I, Aujesky D, Butler J, Vittinghoff E, Simonsick E, et al. (2012) Framingham Risk Score and Alternatives for Prediction of Coronary Heart Disease in Older Adults. PLoS ONE 7(3): e34287. Editor: Weili Zhang, FuWai hospital, Chinese Academy of Medical Sciences, China Received: January 8, 2012; Accepted: February 26, 2012; Published: March 28, 2012 Copyright: © 2012 Rodondi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors have no support or funding to report. Competing interests: The authors have declared that no competing interests exist. Introduction Guidelines for the prevention of coronary heart disease (CHD) recommend the use of risk scores to identify adults at higher risk of CHD for whom preventive therapy–e.g., by lipid lowering drugs–has higher absolute benefits. Several scoring systems exist to help clinicians assess the 10-year CHD risk,,, with the Framingham risk score (FRS) the most widely used.

US Guidelines for the prescription of lipid-lowering drug therapy and aspirin in primary prevention are based on the risk estimations provided by the FRS. Most risk scores were developed in white middle-aged populations,,. Thus, it is uncertain whether risk estimates based on these scores can be generalized to the elderly. The FRS, for example, was developed in a white middle-aged population with a mean age of 49 years and included persons as young as 30 and none older than 74. Actual risk prediction with FRS might perform less well in older adults compared to middle-aged adults, and some traditional risk factors have weaker associations with CHD risk in the elderly; for example, total and LDL-cholesterol are strong cardiovascular risk factors in middle-aged but not in older adults. As it remains unclear whether and how CHD risk prediction might be improved in the growing population of elderly to facilitate primary prevention strategies, we aimed to compare the prognostic performance of 1) the FRS, directly and 2) after recalibration, and 3) with functions derived from the Health ABC Study, a cohort of elderly white and black men and women. We also aimed to assess 4) the utility of adding routinely available lifestyle and simple laboratory variables not part of the FRS but which have been shown to predict CHD in older adults, such as creatinine, glucose and lifestyle factors (alcohol consumption, physical activity ).