Primary and subsequent coronary risk appraisal: New results from The Framingham Study
Primary and subsequent coronary risk appraisal: New results from The Framingham Study
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DOI：
10.1016/s0002-8703(00)90236-9
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发表时间：
2000-02-01
影响因子：
4.8
通讯作者：
Hartz, SC
中科院分区：
文献类型：
--
作者：
D'Agostino, RB;Russell, MW;Hartz, SC
冠心病仍然是美国和大多数发达国家最常见的慢性疾病之一。临床医生和卫生当局对识别冠心病风险增加的个体很感兴趣。弗雷明汉心脏研究多年来建立了数学“健康风险评估模型”，将风险因素与患冠心病的可能性联系起来。方法和结果来自Framingham心脏研究的原发性和继发性冠心病的新的性别特异性模型已经产生。初级冠心病模型适用于评估无心血管疾病的人的冠心病风险，并包含甘油三酯水平、酒精使用和绝经状态等风险因素，这些风险因素未包括在先前发表的模型中。后续的冠心病模型适用于有冠心病史或缺血性中风的人，在事件发生后的急性期存活。年龄、血脂水平（总胆固醇和高密度脂蛋白胆固醇）和糖尿病状况对男性和女性都很重要。此外，收缩压和吸烟是女性冠心病的重要预测因素。结论这些新模型有助于更好地了解无心血管疾病以及既往有冠心病或卒中的人群中危险因素与冠心病发生之间的关系。随着后一种模型的发展，血脂水平、糖尿病以及女性收缩压和吸烟作为风险独立预测因素的重要性再次得到强调。
Background Coronary heart disease continues to be one of the most common chronic illnesses in the United States and most of the developed world. Clinicians and health authorities have interest in identifying individuals at increased risk of CHD. The Framingham Heart Study has over the years produced mathematical "health risk appraisal models" that relate risk factors to the probability of developing CHD.Methods and Results New sex-specific models from The Framingham Heart Study for primary and secondary (subsequent) CHD have been produced. The primary CHD models are appropriate for assessing CHD risk in persons free of cardiovascular disease and contain risk factors such as triglyceride levels, alcohol use, and menopausal status, risk factors nor included in previously published models. The subsequent CHD models are applicable for persons with a history of CHD or ischemic stroke who have survived the acute period after the event. Age, blood lipid levels (total cholesterol and HDL cholesterol), and diabetes status are significant for men and women. In addition, systolic blood pressure and cigarette smoking are significant predictors of subsequent CHD in women.Conclusions These new models are useful tools for better understanding the relation between risk factors and the occurrences of CHD events in individuals who are free of cardiovascular disease as well as persons who have had a prior CHD event or stroke. With the development of these latter models, the importance of blood lipid levels, diabetes, and, in women, systolic blood pressure and cigarette smoking as independent predictors of risk is once again underscored.