Abstract
BackgroundThe 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.MethodsWe 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.ResultsOver 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.ConclusionsThe 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.
Highlights
Hypertension is a major global health issue due to its high prevalence and importance as a modifiable risk factor for cardiovascular disease and premature mortality all over the world [1]
We aimed to assess the predictive ability of the Framingham hypertension risk score in a Middle Eastern population-based cohort study
Study design and population The Tehran Lipid and Glucose Study (TLGS) is a population-based prospective study consisting of 15,005 participants, aimed to estimate the prevalence and incidence of noncommunicable disease (NCD) [22]; the target population is a representative sample of an urban Iranian population, aged 3 to 69 years, living in Tehran, district No
Summary
Hypertension is a major global health issue due to its high prevalence and importance as a modifiable risk factor for cardiovascular disease and premature mortality all over the world [1]. According to global burden of disease (GBD) 2017, high systolic blood pressure (SBP) is the first leading risk factor for early death and disability, accounting for 10.4 million deaths and 218 million DALYs [5]. Factors including population growth, aging, and behavioral risk factors, such as unhealthy diet, tobacco use, lack of physical activity, excess weight, and exposure to persistent stress, are attributable to the growing prevalence of hypertension [7]. We aimed to assess the predictive ability of this model in a Middle Eastern population. We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models
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