Key result
Framingham hypertension risk score predicts incident hypertension with a strong 0.81 c-index.
Why the study?
The Framingham hypertension risk score is a well-known model for predicting hypertension in adults, 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 incident hypertension in a Middle Eastern population, supporting its use for targeted preventive interventions.
Score discriminates well in Middle Eastern cohort; extends Framingham validation but leaves open preventive use.
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 5,423 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. (2020) conducted a cohort in Hypertension (n=5,423). Framingham Hypertension Risk Score vs. Observed hypertension incidence was evaluated on Discrimination of incident hypertension (c-index) (c-index 0.81, 95% CI 0.79-0.83). The original Framingham hypertension risk score demonstrated good discrimination for predicting incident hypertension with a c-index of 0.81, which improved to 0.82 after model revision.
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