PCV18: FRAMINGHAM RISK EQUATIONS PREDICT HOSPITAL USAGE AND MORTALITY

Abstract

Risk equations based on the Framingham Heart Study (FHS) are used in NZ to predict the 5y risk of incident cardiovascular (CV) events. OBJECTIVE: To establish how well the FHS equations predict first hospitalisation or mortality from CV events in a New Zealand (NZ) population without overt CV disease. METHODS: Observations were taken from a cohort study with 6354 (4638 M +1716 F) participants age 32–74 without known CV disease, taken from the workforce of a nation-wide multi-industry corporation plus a random sample of the Auckland electoral rolls. Prognostic factors were assessed in 1992/93 by a questionnaire plus physiological measurements (BP, cholesterol etc.). Age-specific risk predictions from the FHS were compared with age-specific mortality plus relevant hospital discharges from January 1988 to December 1998 (NZ Health Information Service). RESULTS: The 5y incidence of first hospitalisation for any CV event was 6.4% (male) and 4.4% (female). Table 1 compares observed hospitalised events or mortality with predicted incident events, averaged across 5y age bands. CONCLUSIONS: FHS risk equations accurately predict age-specific incident hospitalized CHD or stroke events or mortality for NZ males age 30–74 but under-estimate MI events. Prediction is less accurate and precise for females. Ratio of observed to predicted events, averaged across 8 × 5y age bands Mean ratio (±SD) Male Female Both CHD 1.03 ± 0.15 0.92 ± 0.35 1.03 ± 0.06 MI 1.24 ± 0.19 1.49 ± 1.19 1.26 ± 0.15 STROKE 0.98 ± 0.40 0.74 ± 0.57 0.94 ± 0.42