Validating the Framingham Hypertension Risk Score: A 4‐year follow‐up from the Brazilian Longitudinal Study of the Adult Health (ELSA‐Brasil)

AbstractWe investigated whether high adherence to the Dietary Approaches to Stop Hypertension (DASH) diet was independently associated with lower risk of incident hypertension. Participants included 5632 adults, without hypertension at the baseline (2008–2010) of the Longitudinal Study of Adult Health, who took part in the second follow-up visit (2012–2014). Adherence to the DASH diet was estimated at baseline using a score based on eight food items (final scores from 8 to 40 points) and was categorised as high adherence (≥30 points, or ≥75 %) and low adherence (<75 %; reference). Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg, or use of antihypertensive drugs. The association between adherence to the DASH diet and the risk of incident hypertension was estimated using Cox regression models adjusted by covariates. In total, 780 new cases of hypertension (13·8 %) were identified in about 3·8-year follow-up. Participants with high adherence to the DASH diet had 26 % lower risk of hypertension (hazard ratio (HR) 0·74; 95 % CI 0·57, 0·95) after adjustment for socio-demographic characteristics, health-related behaviours, diabetes and family history of hypertension. The HR reduced to 0·81 (95 % CI 0·63, 1·04) and was of borderline statistical significance after adjustment for BMI, suggesting that lower body weight explains about 10 % of the association between high adherence to the DASH diet and hypertension risk reduction. The results indicate that high adherence to the DASH diet lowered the risk of hypertension by one-fourth over a relatively short follow-up period.

Download Full-text

Validation of the Framingham hypertension risk score in a middle eastern population: Tehran lipid and glucose study (TLGS)

BMC Public Health ◽

10.1186/s12889-021-10760-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fatemeh Koohi ◽

Ewout W. Steyerberg ◽

Leila Cheraghi ◽

Alireza Abdshah ◽

Fereidoun Azizi ◽

...

Keyword(s):

Simple Model ◽

Risk Score ◽

Screening Tool ◽

Middle Eastern ◽

Predictive Ability ◽

Eastern Population ◽

Hypertension Risk ◽

Graphical Comparison ◽

Middle Eastern Population

Abstract Background The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. Methods We studied 5423 participants, aged 20–69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. Results Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79–0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. Conclusions The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.

Download Full-text

Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Public Health Nutrition ◽

10.1017/s1368980019002854 ◽

2019 ◽

Vol 23 (6) ◽

pp. 1076-1086 ◽

Cited By ~ 18

Author(s):

Scheine Leite Canhada ◽

Vivian Cristine Luft ◽

Luana Giatti ◽

Bruce Bartholow Duncan ◽

Dora Chor ◽

...

Keyword(s):

Longitudinal Study ◽

Waist Circumference ◽

Overweight And Obesity ◽

Processed Foods ◽

Adult Health ◽

Processed Food ◽

Central Adiposity ◽

Robust Variance ◽

Large Weight

AbstractObjective:To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort.Design:We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity.Setting:Brazil.Participants:Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35–74 years at baseline (2008–2010).Results:UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF.Conclusions:Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.

Download Full-text

Incidence of TPOAb over a 4-year follow-up period: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Archives of Endocrinology and Metabolism ◽

10.20945/2359-3997000000422 ◽

2021 ◽

Author(s):

Isabela M. Benseñor ◽

Carolina Castro Porto Silva Janovsky ◽

Alessandra C. Goulart ◽

Itamar de Souza Santos ◽

Maria de Fátima Haueisen Sander Diniz ◽

...

Keyword(s):

Longitudinal Study ◽

Adult Health

Download Full-text

Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0686 ◽

2016 ◽

Vol 54 (5) ◽

Cited By ~ 7

Author(s):

Chams B. Maluf ◽

Sandhi M. Barreto ◽

Rodrigo C.P. dos Reis ◽

Pedro G. Vidigal

Keyword(s):

Risk Factors ◽

Longitudinal Study ◽

Risk Score ◽

Framingham Risk Score ◽

Linear Regression Analysis ◽

Adult Health ◽

Platelet Volume ◽

Cvd Risk ◽

Distribution Width ◽

Framingham Risk

AbstractBackground:Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS).Methods:Baseline data (2008–2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS.Results:Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR.Conclusions:Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.

Download Full-text

Validation of the Framingham Hypertension Risk Score in A Middle Eastern Population: Tehran Lipid and Glucose Study (TLGS)

10.21203/rs.3.rs-111198/v1 ◽

2020 ◽

Author(s):

Fatemeh Koohi ◽

Ewout Steyerberg ◽

Leila Cheraghi ◽

Alireza Abdshah ◽

Fereidoun Azizi ◽

...

Keyword(s):

Simple Model ◽

Risk Score ◽

Screening Tool ◽

Middle Eastern ◽

Predictive Ability ◽

Eastern Population ◽

Hypertension Risk ◽

Graphical Comparison ◽

Middle Eastern Population

Abstract Background: The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. Methods: We studied 5,423 participants, aged 20-69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. Results: Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index=0.81, 95% CI: 0.79-0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. Conclusions: The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.

Download Full-text