scholarly journals Correction of the Framingham Risk Score Data Reported in SPRINT

2017 ◽  
Author(s):  
Frederick Warner ◽  
Sanket S. Dhruva ◽  
Joseph S. Ross ◽  
Pranammya Dey ◽  
Karthik Murugiah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
New England ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Heart Association ◽  
Pharmacologic Therapy ◽  
Total Study Population ◽  
Blood Pressure Targets ◽  
Framingham Risk ◽  
Study Participants

This report describes an error in the Framingham Risk Score data presented in the original SPRINT publication.1 The data, presented in Table 1 of the main SPRINT publication in the New England Journal of Medicine and made available to SPRINT Challenge participants, incorrectly calculated the level of baseline cardiovascular risk of the study participants using the Framingham Risk Score. The correct calculation increased the number of participants identified as having >15% 10-year risk from 5737 to 7089, a change from 61% to 76% of the total study population. This information is important for researchers attempting to validate and extend the trial’s findings and is particularly germane because the recently released American Heart Association/American College of Cardiology blood pressure guidelines changed blood pressure targets for pharmacologic therapy only for high-risk individuals.

scholarly journals Accurate estimation of cardiovascular risk in a non-diabetic adult: detecting and correcting the error in the reported Framingham Risk Score for the Systolic Blood Pressure Intervention Trial population

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021685 ◽  
Author(s):  
Frederick Warner ◽  
Sanket S Dhruva ◽  
Joseph S Ross ◽  
Pranammya Dey ◽  
Karthik Murugiah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Intervention Trial ◽  
Framingham Risk ◽  
Study Population ◽  
Study Participants

ObjectivesTo understand the discrepancy between the published 10-year cardiovascular risk and 10-year cardiovascular risk generated from raw data using the Framingham Risk Score for participants in the Systolic Blood Pressure Intervention Trial (SPRINT).DesignSecondary analysis of SPRINT data published inThe New England Journal of Medicine(NEJM) and made available to researchers in late 2016.SettingSPRINT clinical trial sites.ParticipantsStudy participants enrolled into SPRINT.ResultsThe number of SPRINT study participants identified as having ≥15% 10-year cardiovascular risk was not consistent with what was reported in the original publication. Using the data from the trial, the Framingham Risk Score indicated ≥15% 10-year cardiovascular risk for 7089 participants compared with 5737 reported in the paper, a change from 61% to 76% of the total study population.ConclusionsThe analysis of the clinical trial data by independent investigators identified an error in the reporting of the risk of the study population. The SPRINT trial enrolled a higher risk population than was reported in the initial publication, which was brought to light by data sharing.

scholarly journals Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

2013 ◽  
Vol 17 (10) ◽  
pp. 2246-2252 ◽  
Author(s):  
Reci Meseri ◽  
Reyhan Ucku ◽  
Belgin Unal
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Undiagnosed Diabetes ◽  
Anthropometric Measurement ◽  
Cardiovascular Risks ◽  
Framingham Risk ◽  
Chd Risk ◽  
Diabetes Status

AbstractObjectiveTo determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR.DesignPopulation-based cross-sectional study.SettingBalcova, Izmir, Turkey.SubjectsIndividuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as ‘medium or high risk’.ResultsAmong the participants, 67·7 % were female, 38·2 % were obese, 24·5 % had high blood pressure, 9·2 % had diabetes, 1·5 % had undiagnosed diabetes (≥126 mg/dl), 22·0 % had high total cholesterol and 45·9 % had low HDL-cholesterol. According to Framingham risk score, 32·7 % of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0·55 was the optimal cut-off point for WHtR for CHD risk.ConclusionsBMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of ‘0·5’ can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.

P4450Atherosclerosis in women with systemic lupus erythematosus with and without nephritis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Panafidina ◽  
T V Popkova ◽  
D S Novikova
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Blood Pressure ◽  
Disease Activity ◽  
Risk Score ◽  
Lupus Erythematosus ◽  
Framingham Risk Score ◽  
Systemic Lupus ◽  
Framingham Risk ◽  
Coronary Events

Abstract Background Nephritis in systemic lupus erythematosus (SLE) is a factor contributing to early development of atherosclerosis (AS). Objectives The aim of the study is to determine differences in cardiovascular risk factors and AS in SLE pts with and without lupus nephritis (LN). Methods The study included 162 females, age 35 [26–43] years (median [interquartile range 25–75%])) with SLE (ACR,1997). We divided SLE pts on two groups, comparable in age: the 1st group is the pts with LN (n=84, 52%), the 2nd - without LN (n=78, 48%). We considered traditional factors of cardiovascular disease (CVD): (smoking, family history of CVD, blood pressure, cholesterol (total, HDL, LDL) and triglyceride (TG) levels, body mass index, diabetes mellitus) and SLE-related factors (age at onset, duration, clinical features, SLE Disease Activity Index (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics damage index (SLICC/DI), treatment with steroids); intima-media thickness (IMT) and the 10-year risk for coronary events. Carotid intima-media wall thickness of common carotid arteries was measured by high resolution B-mode ultrasound. The 10-year risk for coronary events was estimated by the Framingham risk equation. Results Median SLE duration was 8,0 [2,3–17,0] years, SLEDAI 2K – 8 [3–16], SLICC/DI score – 2 [0–3], duration of prednisone treatment – 72 [26–141] months. SLE pts from the 1st group had higher prevalence of hypertension (61% vs 36%, p<0,01), systolic blood pressure (130 [110–150] vs 120 [110–130]mm Hg, p<0,01), diastolic blood pressure (80 [70–95] vs 70 [70–80] mm Hg, p<0,05), TG concentration (136 [98–184] vs 100 [61–162] mg/dl, p<0,01), Framingham Risk Score (5 [1–30] vs 1 [1–27]%, p<0,05), SLEDAI-2K (12 [5–19] vs 4 [2–10], p<0,ehz745.08501), SLICC/DI score (2 [0–4] vs 0 [0–2], p<0,01), prednisone therapy duration (95 [26–192] vs 44 [14–98] months, p<0,05), prednisone cumulative dose (34,4 [13,6–82,5] vs 15,7 [6,2–35,2] g, p<0,001), mean IMT (0,73 [0,65–0,83] vs 0,67 [0,61–0,75] mm, p<0,01), than the pts from the 2nd group. There is no difference in CVD frequency in these groups (17% vs 8%, p=0,084). Conclusions SLE patients with and without LN had no difference in frequency of clinical manifestations of AS (CVD), but had a greater value of mean IMT, Framingham Risk Score and a higher incidence of both traditional (hypertension, TG concentration) and SLE-related (disease activity, prednisone therapy) risk factors for AS.

Changes in hemodynamics in uncomplicated hypertensive crises

2021 ◽  
Vol 41 (1) ◽  
pp. 63-69
Author(s):  
D. V. Leliuk ◽  
◽  
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Antihypertensive Drugs ◽  
Outpatient Basis ◽  
Autonomic Nervous ◽  
Framingham Risk ◽  
Hypertensive Crises

Aim: to improve the results of treatment of uncomplicated hypertensive crises at the prehospital stage by studying the state of systemic hemodynamics, determining the balance of the autonomic nervous system, in patients with hypertension in uncomplicated hypertensive crises. A study of 206 patients with documented stage II hypertension, 75 people who had a stable course of the disease and were examined on an outpatient basis. Almost healthy 31 people the indicators of heart rate variability in the examined persons were analyzed. For diagnosis were recorded according to the standard method “Cardiolab” (KhAI-Medika, Kharkіv). Assessment of the initial vegetative status in patients with hypertension and the direction of its changes after taking antihypertensive drugs, conducted within the framework of acute drug tests, suggests the possibility of differentiated choice of drug therapy and to predict its effectiveness. Reducing blood pressure significantly reduced the % risk, as on a SCORE scale of 5.83 [3.68; 8.66] % to 3.39 [1.87; 6.65] %, (p < 0.05) and Framingham Risk Score with 31.93 [22.72; 43.25] % to 21.74 [15.35; 31.43] %, (p < 0.05). The provision of EMD to patients with GC was generally effective and was accompanied by a significant decrease in CAT by – 3.93 % and DBP by – 12.5 %. Effective reduction of blood pressure led to a reduction in cardiovascular risk, both on the SCORE scale and the Framingham Risk Score. Assignment of differentiated EMD to patients with HA depending on the balance of the (autonomic nervous system) ANS was effective and was accompanied by normalization of total peripheral vascular resistance.

The impact of bariatric surgery on framingham risk score

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.K.H Ho ◽  
C.J O'Boyle ◽  
H Shabana ◽  
K.J Lee
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Risk Reduction ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Density Lipoprotein ◽  
T Test ◽  
Cvd Risk ◽  
Framingham Risk ◽  
The Impact

Abstract Introduction Although morbid obesity is strongly associated with cardiovascular disease (CVD) risk, relatively little research has been performed to evaluate the long-term effect of bariatric surgery (BS) on CVD risk reduction. Purpose To evaluate the 2-year effects of laparoscopic gastric bypass (LGBYP) & laparoscopic sleeve gastrectomy (LSG) on blood pressure, lipid profile, diabetic profile and Framingham risk score (FRS). Methods It was a retrospective review of patients undergoing BS between January 2009–2017. Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), lipid & diabetic profile were recorded preoperatively & 2-year postoperatively. Results Of 416 patients, 77% (320) were females, 88% (365) were non-smokers & mean (sd) age was 48 (11) years. 69% (286) underwent LGBYP. 27% (114) were diabetic, 78% (324) were hyperlipidaemic and 65% (269) were hypertensive. The mean SBP & DBP decreased progressively while mean high-density-lipoprotein (HDL) & total-cholesterol (TC) increased progressively (table 1). LGBYP has a greater reduction in DBP than LSG (p&lt;0.001, t-test). 10-year CVD risk reduced by 37% at 2-year, with a greater effect in LGBYP than LSG (40% vs 28%, p&lt;0.001, t-test). Conclusion The 10-year risk of CVD reduced by 37% 2-years after bariatric surgery, with a greater risk reduction in LGBYP compared to LSG. Funding Acknowledgement Type of funding source: None

scholarly journals Performance of cardiovascular risk scores in mortality prediction ten years after Acute Coronary Syndromes

2019 ◽  
Vol 65 (8) ◽  
pp. 1074-1079
Author(s):  
Amanda Aparecida Petek ◽  
Nara Aline Costa ◽  
Filipe Welson Leal Pereira ◽  
Ezequiel Aparecido dos Santos ◽  
Katashi Okoshi ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
American Heart ◽  
Heart Association ◽  
Mortality Prediction ◽  
Risk Scores ◽  
Coronary Syndrome ◽  
Framingham Risk ◽  
Coronary Syndromes

SUMMARY BACKGROUND The objective of this study was to evaluate the performance of the Framingham risk score (FRS) and risk score by the American College of Cardiology/American Heart Association (SR ACC/AHA) in predicting mortality of patients ten years after acute coronary syndrome (ACS). METHODS This is a retrospective cohort study that included patients aged ≥ 18 years with ACS who were hospitalized at the Coronary Intensive Care Unit (ICU) of the Botucatu Medical School Hospital from January 2005 to December of 2006. RESULTS A total of 447 patients were evaluated. Of these, 118 were excluded because the mortality in 10 years was not obtained. Thus, 329 patients aged 62.9 ± 13.0 years were studied. Among them, 58.4% were men, and 44.4% died within ten years of hospitalization. The median FRS was 16 (14-18) %, and the ACC/AHA RS was 18.5 (9.1-31.6). Patients who died had higher values of both scores. However, when we classified patients at high cardiovascular risk, only the ACC/AHA RS was associated with mortality (p <0.001). In the logistic regression analysis, both scores were associated with mortality at ten years (p <0.001). CONCLUSIONS Both FRS and SR ACC/AHA were associated with mortality. However, for patients classified as high risk, only the ACC/AHA RS was associated with mortality within ten years.

Abstract P010: Cardiac Risk Factors and 6-Year Change in high-sensitivity Cardiac Troponin-T.

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Bill McEvoy ◽  
Mariana Lazo-Elizondo ◽  
Lu Shen ◽  
Vijay Nambi ◽  
Ron Hoogeveen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Troponin T ◽  
Myocardial Damage ◽  
High Sensitivity ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
Framingham Risk ◽  
Study Participants

Introduction: Troponin measured with a highly sensitive assay (hs-cTNT) can detect subclinical myocardial injury and may be useful for risk stratification. However, little is known about temporal changes in hs-cTNT in the general population. Hypothesis: Traditional cardiac risk factors will predict change in hs cTNT. Methods: We analyzed data from 8698 ARIC Study participants, free of cardiovascular disease, who had hs-cTNT measured at visit 2 (1990-1992) and visit 4 (1996-1998). Hs-cTNT was categorized as: undetectable (<5 ng/L), detectable (5-14 ng/L), and elevated (≥14 ng/L). We examined the association of baseline Framingham Risk Score (FRS) groups (low <10%, intermediate 10-20%, high >20%) and individual cardiac risk factors with change across hs-cTNT categories using Poisson regression and with absolute 6-year change using robust linear regression. Results: Over 6 years, 2124 study participants went from undetectable to detectable or elevated hs-cTNT and 353 went from detectable to elevated hs-cTNT. The mean crude 6-year hs-cTNT change (SD) within FRS groups were; low (+1.3 (6.0) ng/L), intermediate (+2.3 (9.3) ng/L), and high (+3.7 (8.3) ng/L). Higher baseline FRS was associated with an increase in hs-cTNT over 6 years ( Table ). This association was stronger for incident detectable hs-cTNT than for progression from detectable to elevated. Major predictors of change were baseline age, male gender, diabetes and hypertension. Black race/ethnicity and obesity were also associated with categorical hs-cTNT change. In addition to HDL-c, baseline hypercholesterolemia and smoking may be associated with downwards hs-cTNT change. Conclusions: Framingham Risk Score was positively associated with 6-year hs-cTNT change in middle-age adults. The modifiable risk factors primarily driving this association were diabetes, hypertension, and obesity. Additional studies are needed to evaluate if modifying these risk factors can prevent progression of subclinical myocardial damage.

scholarly journals Increased risk of Roma for 10-year development of CVDs based on Framingham Risk Score calculation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Piko ◽  
S Fiatal ◽  
Z Kosa ◽  
J Sandor ◽  
R Adany
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Roma Population ◽  
Framingham Risk

Abstract Background Increased mortality and short life expectancy of Roma are well known epidemiological findings which can be partially explained by the high prevalence of cardiovascular risk factors among them. This study assesses the prevalence of the cardiovascular disease (CVD) risk factors (age, sex, systolic blood pressure, smoking and diabetes status, elevated total and reduced high density lipoprotein cholesterol level (HDL-C)) and the estimation of 10-year risk of development of CVD (CVD in general, coronary heart disease (CHD), myocardial infarction (MI) and stroke) and that of death from CHD and CVD based on the Framingham Risk Score (FRS) in case of the Hungarian general (HG) and Roma (HR) populations. Methods A complex health survey incl. questionnaire based interview, physical examination and laboratory test was carried out in 2018 on the HG and HR populations. The prevalence of different cardiovascular risk factors was defined and FRS was computed and compared between the HG (n = 378) and HR (n = 386) populations. Results The prevalence of diabetes was significantly higher among Roma females compared to females of general population (17.8% vs. 7.7%; p = 0.001) while the average systolic blood pressure level was less elevated among Roma males (127.9 mmHg vs. 129.4 mmHg; p = 0.020). The prevalence of smoking (males: 63.1% vs. 33.7%; females: 67.6% vs. 31%; p &lt; 0.001) and reduced HDL-C level (males: 40% vs. 25.9%, p = 0.014; females: 55.5% vs. 35.1%, p &lt; 0.001) were significantly higher in both sexes among Roma. The 10-year estimated risk for development of CHD, MI and CVD and the death from CHD was significantly (P &lt; 0.05) higher in both sexes among Roma compared to the general population while the average risk scores for stroke and death from CVD were significantly higher only among Roma men. Conclusions Our results show that both sexes in the Roma population have a significantly higher risk for 10-year development of CVD compared to the Hungarian general population. Key messages The Roma population have a significantly higher risk for 10-year development of cardiovascular diseases and death from them based on the Framingham Risk Score. The targeted cardiovascular interventions should be focus on reduce smoking and provide information on the recognition and treatment of diabetes and lipid disorders among Roma.

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