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March 17, 2006HeartOpen Access

Cardiovascular disease risk assessment in older women: can we improve on Framingham? British Women’s Heart and Health prospective cohort study

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Why the study?

Does a simple general practice risk assessment model predict coronary heart disease and cardiovascular disease events as accurately as the Framingham model in older women?

Population

3,582 women aged 60 to 79 years who were free of coronary heart disease at entry into the British Women's…

Comparison

A general practice cardiovascular risk… vs The standard Framingham risk model.

Design

Cohort

Follow-up

median 4.7 years

Authors

MMMargaret MayJames Madison University

Discussion

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Implication

May offer simpler CVD risk assessment in older women; extends Framingham comparisons but remains hypothesis-generating without outcome trials.

Structured PICO

Does a simple general practice risk assessment model predict coronary heart disease and cardiovascular disease events as accurately as the Framingham model in older women?

P
Population
3,582 women aged 60 to 79 years who were free of coronary heart disease (CHD) at entry into the British Women's Heart and Health prospective cohort study across 23 towns in the United Kingdom.
I
Intervention
A general practice (GP) cardiovascular risk assessment model using age, systolic blood pressure, smoking habit, and self-rated health.
C
Comparator
The standard Framingham risk model (using age, systolic blood pressure, total:HDL cholesterol ratio, smoking, left ventricular hypertrophy, and diabetes).
O
Outcome
Predictive performance (discrimination and calibration) for incident coronary heart disease (CHD) and cardiovascular disease (CVD) events.hard clinical

A simple risk assessment model based on age, systolic blood pressure, smoking habit, and self-rated health performs as well as the Framingham risk score for predicting cardiovascular events in older women, offering a more feasible tool for primary care.

Limitations

  • Events might have been somewhat underascertained close to the end of follow up.
  • Differences in event definition and ascertainment in Framingham compared with this cohort.
  • The Framingham risk score was not designed for patients more than 74 years old.
  • Risk factors measured in epidemiological studies may not adequately reflect the methods of measurement in routine primary care.
  • Predictive performance of the GP model is likely to be overoptimistic as it was evaluated in the same dataset used to estimate the coefficients.

Cite This Study

Margaret May (2006) studied this question.

synapsesocial.com/papers/6a7f495f2ea7eff8c18963cfhttps://doi.org/10.1136/hrt.2005.085381

Topics

Women and heart disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Geographical variation in cardiovascular disease, risk factors, and their control in older women: British Women's Heart and Health Study2003 · 214 citations
  2. 2Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME Study2003 · 265 citations
  3. 3C-Reactive Protein Modulates Risk Prediction Based on the Framingham Score2004 · 447 citations
  4. 4Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial2000 · 279 citations
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