From the Framingham Heart Study, National Heart, Lung, and Blood
Institute, Framingham, Mass (P.W.F.W., D.L.); Boston University Mathematics
Department, Boston, Mass (R.B.D., A.M.B., H.S.); and Framingham Heart Study,
Boston University School of Medicine, Framingham, Mass (W.B.K.).
Background—The objective of this
study was to examine the association of Joint National Committee
(JNC-V) blood pressure and National Cholesterol Education
Program (NCEP) cholesterol categories with coronary
heart disease (CHD) risk, to incorporate them into coronary
prediction algorithms, and to compare the discrimination properties of
this approach with other noncategorical prediction functions.
Methods and Results—This work was designed as a prospective,
single-center study in the setting of a community-based cohort. The
patients were 2489 men and 2856 women 30 to 74 years old at baseline
with 12 years of follow-up. During the 12 years of follow-up, a total
of 383 men and 227 women developed CHD, which was significantly
associated with categories of blood pressure, total
cholesterol, LDL cholesterol, and HDL
cholesterol (all P<.001). Sex-specific
prediction equations were formulated to predict CHD risk according to
age, diabetes, smoking, JNC-V blood pressure categories, and NCEP total
cholesterol and LDL cholesterol categories. The
accuracy of this categorical approach was found to be comparable to CHD
prediction when the continuous variables themselves were used.
After adjustment for other factors,
Conclusions—Recommended guidelines of blood pressure, total
cholesterol, and LDL cholesterol effectively
predict CHD risk in a middle-aged white population sample. A simple
coronary disease prediction algorithm was developed using
categorical variables, which allows physicians to predict
multivariate CHD risk in patients without overt CHD.
© 1998 American Heart Association, Inc.
Special Reports
Prediction of Coronary Heart Disease Using Risk Factor Categories
28% of CHD events in men and
29% in women were attributable to blood pressure levels that exceeded
high normal (
130/85). The corresponding multivariable-adjusted
attributable risk percent associated with elevated total
cholesterol (200 mg/dL) was 27% in men and 34% in
women.
Key Words: coronary disease • prediction • hypertension • cholesterol
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D. S. Frankel, R. S. Vasan, R. B. D'Agostino Sr, E. J. Benjamin, D. Levy, T. J. Wang, and J. B. Meigs Resistin, Adiponectin, and Risk of Heart Failure: The Framingham Offspring Study J. Am. Coll. Cardiol., March 3, 2009; 53(9): 754 - 762. [Abstract] [Full Text] [PDF]
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 I. Lekander, F. Borgstrom, O. Strom, N. Zethraeus, and J. A Kanis Cost-effectiveness of hormone replacement therapy for menopausal symptoms in the UK Menopause Int, March 1, 2009; 15(1): 19 - 25. [Abstract] [Full Text] [PDF]
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 S. E. Hampson, L. R. Goldberg, T. M. Vogt, T. A. Hillier, and J. P. Dubanoski Using Physiological Dysregulation to Assess Global Health Status: Associations with Self-rated Health and Health Behaviors J Health Psychol, March 1, 2009; 14(2): 232 - 241. [Abstract] [PDF]
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 F Cacciapaglia, E. Zardi, G Coppolino, F Buzzulini, D Margiotta, L Arcarese, M Vadacca, A Amoroso, and A Afeltra Stiffness parameters, intima-media thickness and early atherosclerosis in systemic lupus erythematosus patients Lupus, March 1, 2009; 18(3): 249 - 256. [Abstract] [PDF]
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 J. Hopkins and M. Limacher The Role of Aspirin in Cardiovascular Disease Prevention in Women American Journal of Lifestyle Medicine, March 1, 2009; 3(2): 123 - 134. [Abstract] [PDF]
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 J. Stirrup, K. Wechalekar, A. Maenhout, and C. Anagnostopoulos Cardiac radionuclide imaging in stable coronary artery disease and acute coronary syndromes Br. Med. Bull., March 1, 2009; 89(1): 63 - 78. [Abstract] [Full Text] [PDF]
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A. Adolphe, L. S. Cook, and X. Huang A Cross-sectional Study of Intima-Media Thickness, Ethnicity, Metabolic Syndrome, and Cardiovascular Risk in 2268 Study Participants Mayo Clin. Proc., March 1, 2009; 84(3): 221 - 228. [Abstract] [Full Text] [PDF]
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S. J. Lester, M. F. Eleid, B. K. Khandheria, and R. T. Hurst Carotid Intima-Media Thickness and Coronary Artery Calcium Score as Indications of Subclinical Atherosclerosis Mayo Clin. Proc., March 1, 2009; 84(3): 229 - 233. [Abstract] [Full Text] [PDF]
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 M. F. Engberink, J. M. Geleijnse, N. de Jong, H. A. Smit, F. J. Kok, and W. M. M. Verschuren Dairy Intake, Blood Pressure, and Incident Hypertension in a General Dutch Population J. Nutr., March 1, 2009; 139(3): 582 - 587. [Abstract] [Full Text] [PDF]
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B. Kuczynski, W. Jagust, H. C. Chui, and B. Reed An inverse association of cardiovascular risk and frontal lobe glucose metabolism Neurology, February 24, 2009; 72(8): 738 - 743. [Abstract] [Full Text] [PDF]
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S. A. Mullen, D. E. Crompton, P. W. Carney, I. Helbig, and S. F. Berkovic A neurologist's guide to genome-wide association studies Neurology, February 10, 2009; 72(6): 558 - 565. [Abstract] [Full Text] [PDF]
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 A. M. Kulminski, K. G. Arbeev, I. V. Culminskaya, S. V. Ukraintseva, K. Christensen, and A. I. Yashin Health-Related Phenotypes and Longevity in Danish Twins J Gerontol A Biol Sci Med Sci, February 10, 2009; (2009) gln051v1. [Abstract] [Full Text] [PDF]
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J. L. Warner Risk Prediction Versus Diagnosis: Preserving Clinical Nuance in a Binary World Ann Intern Med, February 3, 2009; 150(3): 222 - 222. [Full Text] [PDF]
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G. Silbernagel, G. Fauler, W. Renner, E. M. Landl, M. M. Hoffmann, B. R. Winkelmann, B. O. Boehm, and W. Marz The relationships of cholesterol metabolism and plasma plant sterols with the severity of coronary artery disease J. Lipid Res., February 1, 2009; 50(2): 334 - 341. [Abstract] [Full Text] [PDF]
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L. P. van der Zwan, T. Teerlink, J. M. Dekker, R. M. A. Henry, C. D. A. Stehouwer, C. Jakobs, R. J. Heine, and P. G. Scheffer Circulating oxidized LDL: determinants and association with brachial flow-mediated dilation J. Lipid Res., February 1, 2009; 50(2): 342 - 349. [Abstract] [Full Text] [PDF]
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J. P.A. Ioannidis Prediction of Cardiovascular Disease Outcomes and Established Cardiovascular Risk Factors by Genome-Wide Association Markers Circ Cardiovasc Genet, February 1, 2009; 2(1): 7 - 15. [Abstract] [Full Text] [PDF]
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 M. NIKPOUR, D. D. GLADMAN, D. IBANEZ, I. N. BRUCE, R. J. BURNS, and M. B. UROWITZ Myocardial Perfusion Imaging in Assessing Risk of Coronary Events in Patients with Systemic Lupus Erythematosus J Rheumatol, February 1, 2009; 36(2): 288 - 294. [Abstract] [Full Text] [PDF]
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 T. Shah, J. P Casas, J. A Cooper, I. Tzoulaki, R. Sofat, V. McCormack, L. Smeeth, J. E Deanfield, G. D Lowe, A. Rumley, et al. Critical appraisal of CRP measurement for the prediction of coronary heart disease events: new data and systematic review of 31 prospective cohorts Int. J. Epidemiol., February 1, 2009; 38(1): 217 - 231. [Abstract] [Full Text] [PDF]
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NACB LMPG Committee Members, G. L. Myers, R. H.M. Christenson, M. Cushman, C. M. Ballantyne, G. R. Cooper, C. M. Pfeiffer, S. M. Grundy, D. R. Labarthe, D. Levy, et al. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Emerging Biomarkers for Primary Prevention of Cardiovascular Disease Clin. Chem., February 1, 2009; 55(2): 378 - 384. [Abstract] [Full Text] [PDF]
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A. D. Hingorani, T. Shah, J. P. Casas, S. E. Humphries, and P. J. Talmud C-Reactive Protein and Coronary Heart Disease: Predictive Test or Therapeutic Target? Clin. Chem., February 1, 2009; 55(2): 239 - 255. [Abstract] [Full Text] [PDF]
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WRITING GROUP MEMBERS, D. Lloyd-Jones, R. Adams, M. Carnethon, G. De Simone, T. B. Ferguson, K. Flegal, E. Ford, K. Furie, A. Go, et al. Heart Disease and Stroke Statistics--2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 27, 2009; 119(3): e21 - e181. [Full Text] [PDF]
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J. D. Berry, K. Liu, A. R. Folsom, C. E. Lewis, J. J. Carr, J. F. Polak, S. Shea, S. Sidney, D. H. O'Leary, C. Chan, et al. Prevalence and Progression of Subclinical Atherosclerosis in Younger Adults With Low Short-Term but High Lifetime Estimated Risk For Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults Study and Multi-Ethnic Study of Atherosclerosis Circulation, January 27, 2009; 119(3): 382 - 389. [Abstract] [Full Text] [PDF]
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G. Karthikeyan, K. K. Teo, S. Islam, M. J. McQueen, P. Pais, X. Wang, H. Sato, C. C. Lang, C. Sitthi-Amorn, M.R. Pandey, et al. Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. J. Am. Coll. Cardiol., January 20, 2009; 53(3): 244 - 253. [Abstract] [Full Text] [PDF]
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