Coronary risk prediction in adults (the Framingham Heart Study)

The Framingham Heart Study, an ongoing prospective study of adult men and women, has shown that certain risk factors can be used to predict the development of coronary artery disease. These factors include age, gender, total cholesterol level, high density lipoprotein cholesterol level, systolic blood pressure, cigarette smoking, glucose intolerance and cardiac enlargement (left ventricular hypertrophy on electrocardiogram or enlarged heart on chest x-ray). Calculators and computers can be easily programmed using a multivariate logistic function that allows calculation of the conditional probability of cardiovascular events. These determinations, based on experience with 5,209 men and women participating in the Framingham study, estimate coronary artery disease risk over variable periods of follow-up. Modeled incidence rates range from less than 1% to greater than 80% over an arbitrarily selected 6-year interval; however, they are typically less than 10%, and rarely exceed 45% in men and 25% in women.