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  • The Framingham scores overestimated the risk for coronary heart disease in Japanese, Hispanic, and native American cohorts

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Clinical prediction guide
The Framingham scores overestimated the risk for coronary heart disease in Japanese, Hispanic, and native American cohorts

https://doi.org/10.1136/ebm.7.1.31

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    D'Agostino RB Sr, Grundy S, Sullivan LM, et al, for the CHD Risk Prediction Group. Validation of the Framingham coronary heart disease prediction scores. Results of a multiple ethnic groups investigation.JAMA2001 Jul 11;286:180–7.
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 QUESTION: Can the Framingham scores, originally developed in a white middle class population, predict the risk for coronary heart disease (CHD) in ethnically diverse populations?

    Design

    Validation of the Framingham scores in 6 ethnically diverse cohorts.

    Setting

    USA.

    Patients

    The Framingham cohort included white participants without CHD. The validation cohorts included the Atherosclerosis Risk in Communities Study (white and black participants), the Physicians' Health Study (white men), the Honolulu Heart Program (Japanese-American men), the Puerto Rico Heart Health Program (Hispanic men), the Strong Heart Study (Native American participants), and the Cardiovascular Health Study (white participants).

    Description of prediction guide

    The Framingham cohort was used to develop sex-specific Cox proportional-hazards regression functions relating CHD risk factors (age, blood pressure, cholesterol concentrations, current smoking, and presence of diabetes) to the occurrence of coronary death or myocardial infarction (CHD events). Functions relating the same CHD risk factors to CHD events were …

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    Footnotes

    • Source of funding: National Heart, Lung and Blood Institute.

    • For correspondence: Dr R B D'Agostino, Sr., Department of Mathematics and Statistics, Boston University, 111 Cummington Street, Boston, MA 02215, USA. Ralph{at}bu.edu.