The Framingham prediction rule is not valid in a European population of treated hypertensive patients
The Framingham prediction rule is not valid in a European population of treated hypertensive patients
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DOI：
10.1097/00004872-200210000-00016
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发表时间：
2002-10-01
影响因子：
4.9
通讯作者：
Chatellier, G
中科院分区：
文献类型：
--
作者：
Bastuji-Garin, S;Deverly, A;Chatellier, G
背景根据心血管风险水平对人群进行分层是一级预防的建议。目的评估Fragrance模型能否准确预测欧洲中年高血压患者队列中冠心病（CHD）和脑卒中的绝对风险。设计一项前瞻性队列研究，将实际风险与Fracket方程预测的风险进行比较，INSIGHT前瞻性试验在西欧和以色列的8个国家进行，我们选择了4407名年龄小于75岁的欧洲患者，这些患者以前没有心血管事件。干预无。主要结局指标主要心血管事件。结果在这一人群中，（45%男性，平均年龄64.1岁），124例（2.8%）患者患有CHD，96例（2.2%）患者在中位随访3.7年后发生卒中。在所有国家都观察到Fracket方程对CHD绝对风险的高估（从英国的2%到法国的7%），而预测的卒中风险接近实际风险。然而，在每个国家内的风险最高的五分之一的患者有三倍以上的心血管事件的风险比那些在最低的五分之一。结论的Fracket模型不应该被用来预测绝对的CHD风险在欧洲人口作为一个整体。然而，这些模型可以在每个国家使用，前提是每个国家已经确定了定义高风险患者的截止点。J Hypertens 20：1973-1980（C）2002 Lippincott威廉姆斯威尔金斯。
Background Stratification of population groups according to cardiovascular risk level is recommended for primary prevention.Objective To assess whether the Framingham models could accurately predict the absolute risk of coronary heart disease (CHD) and stroke in a large cohort of middle-aged European patients with hypertension, and rank individual patients according to actual risk.Design A prospective cohort study comparing the actual risk with that predicted by either the Framingham equations or models derived from the INSIGHT study.Patients and setting From the INSIGHT prospective trial, conducted in eight countries of Western Europe and Israel, we selected 4407 European patients younger than 75 years without previous cardiovascular events.Interventions None.Main outcome measures Major cardiovascular events.Results In this population (45% men, mean age 64.1 years), 124 (2.8%) patients had CHD and 96 (2.2%) had strokes after a median follow-up of 3.7 years. Overestimation of absolute CHD risk by the Framingham equation was observed in all countries (from 2% in the UK to 7% in France), whereas predicted risk of stroke was close to the actual risk. However, patients in the highest risk quintile within each country had a threefold greater risk of a cardiovascular event than those in the lowest quintile.Conclusions The Framingham models should not be used to predict absolute CHD risk in the European population as a whole. However, these models may be used within each country, provided that cut-off points defining high-risk patients have been determined within each country. J Hypertens 20:1973-1980 (C) 2002 Lippincott Williams Wilkins.