Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: The FRESCO Study

Abstract Objective To derive and validate a set of functions to predict coronary heart disease (CHD) and stroke, and validate the Framingham-REGICOR function. Method Pooled analysis of 11 population-based Spanish cohorts (1992–2005) with 50,408 eligible participants. Baseline smoking, diabetes, syst...

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Bibliographic Details
Published in:Preventive medicine 2014-04, Vol.61, p.66-74
Main Authors: Marrugat, Jaume, Subirana, Isaac, Ramos, Rafel, Vila, Joan, Marín-Ibañez, Alejandro, Guembe, María Jesús, Rigo, Fernando, Tormo Díaz, María José, Moreno-Iribas, Conchi, Cabré, Joan Josep, Segura, Antonio, Baena-Díez, José Miguel, de la Cámara, Agustín Gómez, Lapetra, José, Grau, María, Quesada, Miquel, Medrano, María José, González Diego, Paulino, Frontera, Guiem, Gavrila, Diana, Aicua, Eva Ardanaz, Basora, Josep, García, José María, García-Lareo, Manuel, Gutierrez, José Antonio, Mayoral, Eduardo, Sala, Joan, D'Agostino, Ralph, Elosua, Roberto
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Body Mass Index
Cardiology. Vascular system
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cholesterol, HDL - blood
Cohort Studies
Coronary disease
Coronary heart disease
Diabetes
Female
Follow-Up Studies
Heart
Heart diseases
Humans
Hypertension
Internal Medicine
Kaplan-Meier Estimate
Male
Medical sciences
Middle Aged
Miscellaneous
Mortality - trends
Neurology
Prevention
Prevention and actions
Public health. Hygiene
Public health. Hygiene-occupational medicine
Registries
Reproducibility of Results
Risk Assessment
Risk Factors
Risk functions
Risk Reduction Behavior
Sex Factors
Smoking
Spain - epidemiology
Stroke
Strokes
Survival Analysis
Vascular diseases and vascular malformations of the nervous system
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Summary:Abstract Objective To derive and validate a set of functions to predict coronary heart disease (CHD) and stroke, and validate the Framingham-REGICOR function. Method Pooled analysis of 11 population-based Spanish cohorts (1992–2005) with 50,408 eligible participants. Baseline smoking, diabetes, systolic blood pressure (SBP), lipid profile, and body mass index were recorded. A ten-year follow-up included re-examinations/telephone contact and cross-linkage with mortality registries. For each sex, two models were fitted for CHD, stroke, and both end-points combined: model A was adjusted for age, smoking, and body mass index and model B for age, smoking, diabetes, SBP, total and HDL cholesterol, and for hypertension treatment by SBP, and age by smoking and by SBP interactions. Results The 9.3-year median follow-up accumulated 2973 cardiovascular events. The C-statistic improved from model A to model B for CHD (0.66 to 0.71 for men; 0.70 to 0.74 for women) and the combined CHD-stroke end-points (0.68 to 0.71; 0.72 to 0.75, respectively), but not for stroke alone. Framingham-REGICOR had similar C-statistics but overestimated CHD risk. Conclusions The new functions accurately estimate 10-year stroke and CHD risk in the adult population of a typical southern European country. The Framingham-REGICOR function provided similar CHD prediction but overestimated risk.
ISSN:0091-7435
1096-0260
DOI:10.1016/j.ypmed.2013.12.031