Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study
Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study
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DOI：
10.1136/bmj.325.7375.1271
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发表时间：
2002-11-30
影响因子：
--
通讯作者：
Kerry, SM
中科院分区：
文献类型：
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作者：
Cappuccio, FP;Oakeshott, P;Kerry, SM
目的比较冠心病（CHD）、脑卒中和合并心血管疾病（CVD）的10年危险度，采用Fracket方程进行估计。设计基于人群的横断面调查。地点：南伦敦的9个全科诊所。人群1386名男性和女性，年龄40 - 59岁，无CVD病史（475名白色人、447名南亚人和464名非洲裔人），以及1069名无已知糖尿病、左心室肥大、外周血管疾病、肾损害的亚组，结果非洲裔人群冠心病的10年风险估计值最低，经年龄和性别校正后，（7.0%，95%置信区间6.5 - 7.5。）与白色人（8.8%，8.2~9.5）和南亚人（9.2%，8.6~9.9）相比，脑卒中的估计风险最高（分别为1.7%（1.5~1.9），1.4%（1.3~1.6），1.6%（1.5~1.8））。然而，与白色人（11.0 - 12.7）和非洲裔人（10.5%，9.7 - 11.2）相比，南亚人合并CVD的估计风险最高（12.5%，11.6 - 13.4）。在1069人的亚组中，CHD风险大于或等于15%将导致合并心血管疾病风险大于或等于20%的可能性在白色中为91%，在南亚人和非洲裔中为81%。在南亚人和10%的人的非洲血统的冠心病的风险阈值的使用将增加识别那些处于危险中的概率为100%和97%，respectively. Conclusion初级保健医生应使用较低的阈值冠心病的风险时，在非洲或南亚血统的人治疗轻度无并发症的高血压。
Objective To compare the 10 year risk of coronary heart disease (CHD), stroke, and combined cardiovascular disease (CVD) estimated from the Framingham equations.Design Population based cross sectional survey.Setting Nine general practices in south London.Population 1386 men and women, age 40-59 years, with no history of CVD (475 white people, 447 south Asian people, and 464 people of African origin), and a subgroup of 1069 without known diabetes, left ventricular hypertrophy, peripheral vascular disease, renal impairment, or target organ damage.Main outcome measures 10 year risk estimates.Results People of African origin had the lowest 10 year risk estimate of CHD adjusted for age and sex (7.0%, 95% confidence interval 6.5 to 7.5.) compared with white people (8.8%, 8.2 to 9.5) and south Asians (9.2%, 8.6 to 9.9) and the highest estimated risk of stroke (1.7% (1.5 to 1.9),1.4% (1.3 to 1.6),1.6% (1.5 to 1.8), respectively). The estimate risk of combined CVD, however, was highest in south Asians (12.5%, 11.6 to 13.4) compared with white people (11.9%, 11.0 to 12.7) and people of African origin (10.5%, 9.7 to 11.2). In the subgroup of 1069, the probability that a risk of CHD greater than or equal to 15% would identify risk of combined CVD greater than or equal to 20% was 91% in white people and 81% in both south Asians and people of African origin. The use of thresholds for risk of CHD of 12% in south Asians and 10% in people of African origin would increase the probability of identifying those at risk to 100% and 97%, respectively.Conclusion Primary care doctors should use a lower threshold of CHD risk when treating mild uncomplicated hypertension in people of African or south Asian origin.