The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.
Predicting the 30-Year Risk of Cardiovascular Disease: The Framingham Heart Study
Open accessAbstract
Background— Present cardiovascular disease (CVD) risk prediction algorithms were developed for a ≤10-year follow up period. Clustering of risk factors at younger ages and increasing life expectancy suggest the need for longer-term risk prediction tools. Methods and Results— We prospectively followed 4506 participants (2333 women) of the Framingham Offspring cohort aged 20 to 59 years and free of CVD and cancer at baseline examination in 1971–1974 for the development of “hard” CVD events (coronary death, myocardial infarction, stroke). We used a modified Cox model that allows adjustment for competing risk of noncardiovascular death to construct a prediction algorithm for 30-year risk of hard CVD. Cross-validated survival C statistic and calibration χ 2 were used to assess model performance. The 30-year hard CVD event rates adjusted for the competing risk of death were 7.6% for women and 18.3% for men. Standard risk factors (male sex, systolic blood pressure, antihypertensive treatment, total and high-density lipoprotein cholesterol, smoking, and diabetes mellitus), measured at baseline, were significantly related to the incidence of hard CVD and remained significant when updated regularly on follow-up. Body mass index was associated positively with 30-year risk of hard CVD only in models that did not update risk factors. Model performance was excellent as indicated by cross-validated discrimination C=0.803 and calibration χ 2 =4.25 ( P =0.894). In contrast, 30-year risk predictions based on different applications of 10-year functions proved inadequate. Conclusions— Standard risk factors remain strong predictors of hard CVD over extended follow-up. Thirty-year risk prediction functions offer additional risk burden information that complements that of 10-year functions.
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Cites
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Self-citationGeneral Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study
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Cited by
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000625 · Cited by 6,185
2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk
Goff, D. C., Lloyd-Jones, D. M., Bennett, G., Coady, S., D’Agostino, R. B., Gibbons, R., Greenland, P., Lackland, D. T., Levy, D., O’Donnell, C. J., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.005 · Cited by 4,945
Self-citationCosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz486 · Cited by 4,763
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000678 · Cited by 4,536
(2019) · doi:10.1161/cir.0000000000000677 · Cited by 4,501
Metadata
- Authors
- Pencina, M. J., D'Agostino, R. B., Larson, M. G., Massaro, J. M., & Vasan, R. S.
- Venue
- Circulation
- Published
- 2009-06-23
- Volume
- 119
- Issue
- 24
- Pages
- 3078-3084
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2115095782
- Cited by
- 870
- References
- 14
- FWCI
- 50.64
- Type
- journal article
- Language
- en
- Open access
- green
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