Literature DB >> 12458243

Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study.

Francesco P Cappuccio1, Pippa Oakeshott, Pasquale Strazzullo, Sally M Kerry.   

Abstract

OBJECTIVE: To compare the 10 year risk of coronary heart disease (CHD), stroke, and combined cardiovascular disease (CVD) estimated from the Framingham equations.
DESIGN: Population based cross sectional survey.
SETTING: Nine general practices in south London. POPULATION: 1386 men and women, age 40-59 years, with no history of CVD (475 white people, 447 south Asian people, and 464 people of African origin), and a subgroup of 1069 without known diabetes, left ventricular hypertrophy, peripheral vascular disease, renal impairment, or target organ damage. MAIN OUTCOME MEASURES: 10 year risk estimates.
RESULTS: People of African origin had the lowest 10 year risk estimate of CHD adjusted for age and sex (7.0%, 95% confidence interval 6.5 to 7.5) compared with white people (8.8%, 8.2 to 9.5) and south Asians (9.2%, 8.6 to 9.9) and the highest estimated risk of stroke (1.7% (1.5 to 1.9), 1.4% (1.3 to 1.6), 1.6% (1.5 to 1.8), respectively). The estimate risk of combined CVD, however, was highest in south Asians (12.5%, 11.6 to 13.4) compared with white people (11.9%, 11.0 to 12.7) and people of African origin (10.5%, 9.7 to 11.2). In the subgroup of 1069, the probability that a risk of CHD >/=15% would identify risk of combined CVD >/=20% was 91% in white people and 81% in both south Asians and people of African origin. The use of thresholds for risk of CHD of 12% in south Asians and 10% in people of African origin would increase the probability of identifying those at risk to 100% and 97%, respectively.
CONCLUSION: Primary care doctors should use a lower threshold of CHD risk when treating mild uncomplicated hypertension in people of African or south Asian origin.

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Mesh:

Year:  2002        PMID: 12458243      PMCID: PMC136923          DOI: 10.1136/bmj.325.7375.1271

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  20 in total

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  39 in total

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