Framingham risk score and prediction of lifetime risk for coronary heart disease☆
Section snippets
Subjects
The Framingham Heart Study was established in 1948, when 5,209 residents, 28 to 62 years old, of Framingham, Massachusetts, were enrolled in a prospective epidemiologic cohort study. In 1971, an additional 5,124 subjects (offspring of original cohort subjects and spouses of offspring) were enrolled in the Framingham Offspring Study. Study design and entry criteria for the 2 cohorts have been detailed elsewhere.12, 13 For the present analysis, to reflect more contemporary experience, all
Study sample
We followed 2,716 men and 3,500 women from 1971 to 1996. During follow-up, 939 subjects developed CHD and 1,363 died free of CHD. Table 1lists the number of subjects contributing data and the mean Framingham risk scores for each age- and gender-specific risk score tertile. There was a stepwise increase in mean risk score with advancing age, because advancing age confers increased risk for CHD and because of a greater burden of CHD risk factors with advancing age.
Lifetime risk for CHD by Framingham risk score
Table 2presents the lifetime
Discussion
The Framingham risk score, which was designed to predict 10-year risk for CHD, was very effective in predicting the short-term cumulative risk for CHD, even in the context of competing risk of death from noncoronary causes. In women, the risk score was also very effective at stratifying the remaining lifetime risk for CHD, with 1.5- to 3-fold higher absolute risk in the highest versus lowest tertile of risk score at all ages. In men, the risk score discriminated lifetime risk well only at older
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Dr. Lloyd-Jones is supported by grant 1 K23 HL04253 from the National Institutes of Health, Bethesda, Maryland. The Framingham Heart Study is supported by contract N01-HC-25195 from the National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, Maryland.