OBJECTIVE: To estimate the probability of becoming high risk for cardiovascular disease among people at low and intermediate risk and not being treated for high blood pressure or lipid levels. DESIGN: Observational study. SETTING: General communities in Japan and the United States. PARTICIPANTS: 13,757 participants of the Tokyo health check-up study and 3855 of the Framingham studies aged 30-74 years with complete data on risk equation covariates, not receiving blood pressure or cholesterol lowering treatment, and with an estimated risk of cardiovascular disease <20% within 10 years. We stratified participants on the basis of baseline risk: <5%, 5-<10%, 10-<15%, and 15-<20%.We used follow-up measurements from the Tokyo study done annually over three years (2006-10) and follow-up visits in the Framingham study done between eight (1968-75) and 19 years (1990-1995) after baseline. MAIN OUTCOME MEASURE: Estimated 10 year risk of a cardiovascular event >20% using the Framingham equation. RESULTS: At baseline most participants had <5% risk (60.6% of Tokyo cohort and 45.7% of Framingham cohort) or 5-<10% risk (24.0% and 28.0%, respectively) of a cardiovascular event within 10 years. There was <10% probability of crossing the treatment threshold at 19, 8, and 3 years for baseline risk groups <5%, 5-<10%, and 10-<15%, respectively, and >10% probability of crossing the treatment threshold at one year for the 15-<20% baseline risk group. CONCLUSIONS: Decisions on the frequency of remeasuring for cardiovascular risk should be made on the basis of baseline risk. Repeat risk estimation before 8-10 years is not warranted for most people initially not requiring treatment. However, remeasurement within a year seems warranted in those with an initial 15-<20% risk.
OBJECTIVE: To estimate the probability of becoming high risk for cardiovascular disease among people at low and intermediate risk and not being treated for high blood pressure or lipid levels. DESIGN: Observational study. SETTING: General communities in Japan and the United States. PARTICIPANTS: 13,757 participants of the Tokyo health check-up study and 3855 of the Framingham studies aged 30-74 years with complete data on risk equation covariates, not receiving blood pressure or cholesterol lowering treatment, and with an estimated risk of cardiovascular disease <20% within 10 years. We stratified participants on the basis of baseline risk: <5%, 5-<10%, 10-<15%, and 15-<20%.We used follow-up measurements from the Tokyo study done annually over three years (2006-10) and follow-up visits in the Framingham study done between eight (1968-75) and 19 years (1990-1995) after baseline. MAIN OUTCOME MEASURE: Estimated 10 year risk of a cardiovascular event >20% using the Framingham equation. RESULTS: At baseline most participants had <5% risk (60.6% of Tokyo cohort and 45.7% of Framingham cohort) or 5-<10% risk (24.0% and 28.0%, respectively) of a cardiovascular event within 10 years. There was <10% probability of crossing the treatment threshold at 19, 8, and 3 years for baseline risk groups <5%, 5-<10%, and 10-<15%, respectively, and >10% probability of crossing the treatment threshold at one year for the 15-<20% baseline risk group. CONCLUSIONS: Decisions on the frequency of remeasuring for cardiovascular risk should be made on the basis of baseline risk. Repeat risk estimation before 8-10 years is not warranted for most people initially not requiring treatment. However, remeasurement within a year seems warranted in those with an initial 15-<20% risk.
Authors: James A Dickinson; Roland Grad; Brenda J Wilson; Neil R Bell; Harminder Singh; Olga Szafran; Guylène Thériault Journal: Can Fam Physician Date: 2019-05 Impact factor: 3.275
Authors: James A Dickinson; Roland Grad; Brenda J Wilson; Neil R Bell; Harminder Singh; Olga Szafran; Guylène Thériault Journal: Can Fam Physician Date: 2019-05 Impact factor: 3.275
Authors: Joni V Lindbohm; Pyry N Sipilä; Nina J Mars; Jaana Pentti; Sara Ahmadi-Abhari; Eric J Brunner; Martin J Shipley; Archana Singh-Manoux; Adam G Tabak; Mika Kivimäki Journal: Lancet Public Health Date: 2019-04
Authors: Katy Bell; Jenny Doust; Kevin McGeechan; Andrea Rita Horvath; Alexandra Barratt; Andrew Hayen; Christopher Semsarian; Les Irwig Journal: J Hypertens Date: 2021-02-01 Impact factor: 4.776