Key result
Framingham hypertension risk score predicts incident hypertension with 0.81 c-index but requires revision for underestimation.
Why the study?
The Framingham hypertension risk score is a simple predictive model, but its predictive ability needed assessment in a Middle Eastern population.
Does the Framingham hypertension risk score accurately predict the development of hypertension in a Middle Eastern population?
Cohort (n=5,423)
No
Does the Framingham hypertension risk score accurately predict the development of hypertension in a Middle Eastern population?
The revised Framingham hypertension risk score accurately predicts the 3-year risk of developing hypertension in a Middle Eastern population, with a c-index of 0.81.
May support recalibrated Framingham use in Middle Eastern adults; extends validation but leaves generalizability open pending prospective confirmation.
BACKGROUND: The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. METHODS: We studied 5423 participants, aged 20-69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell's concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. RESULTS: Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79-0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. CONCLUSIONS: The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.
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Koohi et al. (2021) conducted a cohort in Non-hypertensive adults (n=5,423). Framingham hypertension risk score was evaluated on Discrimination (c-index) for predicting incident hypertension (c-index 0.81, 95% CI 0.79-0.83). The original Framingham hypertension risk score demonstrated good discrimination for predicting incident hypertension (c-index 0.81) but systematically underestimated risk, which was corrected by model revision.
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