Framingham equations overestimate risk of coronary heart disease mortality in British males*1

Abstract

What is the predictive accuracy of the Framingham risk score for coronary heart disease in a UK population? Prospective cohort study. The Framingham equation significantly over-predicted 10-year coronary heart disease (CHD) mortality (predicted mortality 4.1% vs . observed mortality 2.8%; over-prediction of risk 47%; P <0.0001 for goodness of fit). The Framingham equation significantly over-predicted 10 year CHD event rate (predicted event rate 16.0% vs. observed event rate 10.2%; over-prediction of risk 57%; P <0.0001 for goodness of fit). The Framingham equations over-predict risk of CHD mortality and all fatal and non-fatal CHD events in a representative sample of British men. The disparity seen is likely to represent actual differences in the levels of CHD risk in the Framingham population and the British male population.