American Heart Journal
Volume 148, Issue 1 , Pages 16-26 , July 2004

Concept and usefulness of cardiovascular risk profiles

  • William B Kannel, MD, MPH

      Affiliations

    • National Heart, Lung, and Blood Institute's Framingham Study, National Institutes of Health, Boston University School of Medicine, Framingham, Mass, USA
    • Corresponding Author InformationReprint requests: William B. Kannel, MD, MPH, Framingham Heart Study, 5 Thurber St, Framingham, MA 01702, USA.
    • ,
  • Ralph B D'Agostino, PhD

      Affiliations

    • Department of Mathematics, Boston University, Boston Mass, USA
    • ,
  • Lisa Sullivan, PhD,

      Affiliations

    • Department of Mathematics, Boston University, Boston Mass, USA
    • ,
  • Peter W.F Wilson, MD

      Affiliations

    • National Heart, Lung, and Blood Institute's Framingham Study, National Institutes of Health, Boston University School of Medicine, Framingham, Mass, USA

Received 3 March 2003 ,Accepted 17 October 2003.

References 

  1. Bethesda Conference Report: 27th Bethesda Conference: matching the intensity of risk factor management with the hazard of coronary disease events. J Am Coll Cardiol 1996;27:957–1041
  2. Wood D, DeBacker G, Faegerman O, et al.  Prevention of coronary heart disease in clinical practice (summary of recommendations of the second joint task force of European and other societies on coronary prevention). J Hypertens. 1998;16:1407–1414
  3. Truett J, Cornfield J, Kannel WB. A multivariate analysis of the risk of coronary heart disease in Framingham. J Chronic Dis. 1967;20:511–524
  4. Cornfield J, Gordon T, Smith W. Quantal response curves for experimentally uncontrolled variables. Bull Int Stat Inst 1961;28:part 3
  5. Walker S, Duncan D. Estimation of the probability of an event as a function of several independent variables. Biometrika. 1967;54:167–179
  6. Kannel WB, McGee D, Gordon T. A general cardiovascular risk profile (the Framingham Study). Am J Cardiol. 1976;38:46–51
  7. Anderson KM, Wilson PWF, Odell PM, et al.  An updated coronary risk profile (a statement for health professionals). Circulation. 1991;83:356–362
  8. Wolf PA, D'Agostino RB, Belanger AJ, et al.  Probability of stroke (a risk profile from the Framingham Study). Stroke. 1991;3:312–318
  9. Wilson PWF, D'Agostino RB, Levy D, et al.  Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847
  10. Assmann G, Cullen P, Schulte H. The Munster Heart Study (PROCAM) (results of follow-up at 8 years). Eur Heart J. 1998;19(Suppl A):A2–11
  11. Grundy SM, Balady GJ, Criqui G, et al. Primary prevention of coronary heart disease: guidance from Framingham. A statement for health care professionals from the American Heart Association's Task Force on Risk Reduction. Circulation 1998;97:1876–87
  12. Gordon T, Kannel WB. Multiple risk functions for predicting coronary heart disease (the concept, accuracy and application). Am Heart J. 1982;103:1031–1039
  13. Marshall RJ. The use of classification and regression trees in clinical epidemiology. J Clin Epidemiol. 2001;54:603–609
  14. Dayhoff JE, DeLeo JM. Artificial neural networks (opening the black box). Cancer. 2001;91:1615–1635
  15. Steyerberg EW, Harrell FE, Borsboom GJJM, et al.  Internal validation of predictive models (efficiency of some procedures for logistic regression analysis). J Clin Epidemiol. 2001;54:774–781
  16. D'Agostino RB, Grundy S, Sullivan LM, et al.  Validation of the Framingham coronary heart disease prediction scores (results of a multiple ethnic groups investigation). JAMA. 2001;286:180–187
  17. Kannel WB, Dawber TR, Kagan A, et al.  Factors of risk in the development of coronary heart disease—six-year follow-up experience; the Framingham Study. Ann Intern Med. 1961;55:33–50
  18. Wilson PWF, Kannel WB. Clustering of risk factors, obesity and syndrome X. Nutr Clin Care. 1999;1:44–50
  19. Defronzo RA, Ferranini E. Insulin resistance (a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia and atherosclerotic cardiovascular disease). Diabetes Care. 1991;14:173–194
  20. D'Agostino RB, Russell MW, Huse DM, et al.  Primary and subsequent coronary risk appraisal (new results from the Framingham Study). Am Heart J. 2000;139:272–281
  21. Murabito JM, D'Agostino RB, Silbershatz H, et al.  Intermittent claudication (a risk profile from the Framingham Study). Circulation. 1997;96:44–49
  22. Kannel WB, D'Agostino RB, Silbershatz H, et al.  Profile for estimating risk of heart failure. Arch Intern Med. 1999;159:1197–1204
  23. Kannel WB, Gordon T. Evaluation of cardiovascular risk factors in the elderly (the Framingham Study). Bull N Y Acad Med. 1978;54:573–591
  24. Kannel WB, Sytkowski PA. Atherosclerosis risk factors. Pharmacol Ther. 1987;32:207–235
  25. Kannel WB. Epidemiologic relationship of disease among the different vascular territories. In:  Fuster V,  Ross R,  Topol EJ editor. Atherosclerosis and coronary artery disease. Philadelphia: Lippincott-Raven; 1996;p. 1591–1599
  26. Ho KKL, Kannel WB, Levy D. The epidemiology of heart failure (the Framingham Study). J Am Coll Cardiol. 1993;22(Suppl A):6–13A
  27. Kannel WB, Ho K, Thom T. Changing epidemiological features of cardiac failure. Br Heart J. 1994;72:S3–9
  28. Califf RM, Armstrong PW, Carver JR, et al.  Task Force 5. Stratification of patients into high, medium, and low risk subgroups for purposes of risk factor management. J Am Coll Cardiol. 1996;27:964–1047
  29. Pooling Project Research Group . Relationship of blood pressure, serum cholesterol, smoking habit, relative weight, and ECG abnormalities to the incidence of major coronary events (final report of the pooling project). J Chronic Dis. 1978;31:201–306
  30. Brand RJ, Rosenman RH, Sholtz RI, et al.  Multivariate prediction of coronary heart disease in the Western Collaborative Group Study compared to the findings of the Framingham Study. Circulation. 1976;53:348–355
  31. Leaverton PE, Sorlie PD, Kleinman JC, et al.  Representativeness of the Framingham risk model for coronary heart disease mortality (a comparison with a national cohort study). J Chronic Dis. 1987;40:775–784
  32. McGee D, Gordon T. The results of the Framingham Study applied to four other US-based studies of cardiovascular disease. In:  Kannel WB,  Gordon T editor. The Framingham Study: an epidemiological investigation of cardiovascular disease, section 31. US Dept of Health Education and Welfare publication No. 76-1083. Bethesda (Md): US Government Printing Office; 1976;
  33. Grundy SM, D'Agostino RB, Mosca L, et al.  Cardiovascular risk assessment based on US cohort studies (findings from a National Heart Lung and Blood Institute Workshop). Circulation. 2001;104:491–496
  34. Staessen JA, Fagard R, Thijs L, et al.  Randomized double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Lancet. 1997;350:157–164
  35. SHEP Cooperative Research Group . Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension (final results of the Systolic Hypertension in the Elderly Program (SHEP)). JAMA. 1991;265:3255–3264
  36. Shepherd J, Cobbe SM, Ford I, et al.  Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995;333:1301–1307
  37. Rich-Edwards JW, Manson JE, Hennekens CH, et al.  The primary prevention of coronary heart disease in women. N Engl J Med. 1995;332:1758–1766
  38. Downs JR, Clearfield M, Weis S, et al.  Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels (results of AFCAPS/TexCAPS). JAMA. 1998;279:1615–1622
  39. Bloomfield Rubins H, Robins SJ, Collins D, et al.  Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. N Engl J Med. 1999;341:410–418
  40. Wilson PWF, Kannel WB. Epidemiology of hyperglycemia and atherosclerosis. In:  Ruderman N,  Williamson J,  Brownlee M editor. Hyperglycemia, diabetes, and vascular disease. New York: Oxford University Press; 1992;p. 21–29
  41. Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol. 1990;132:612–628
  42. Krauss RM. Dense low-density lipoproteins and coronary disease. Am J Cardiol. 1995;75:53–57B
  43. Dahlen GH. Lp(a) lipoprotein in cardiovascular disease. Atherosclerosis. 1994;108:111–126
  44. Mayer EL, Jacobsen DW, Robinson K. Homocysteine and coronary atherosclerosis. J Am Coll Cardiol. 1996;27:517–527
  45. Chang M-H, Hahn RA, Teutsch SM, et al.  Multiple risk factors and population attributable risk for ischemic heart disease mortality in the United States, 1971–1992. J Clin Epidemiol. 2001;54:638–644

☆ Framingham Study research is supported by the National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI Contract N01-HC-38038) and the Visiting Scientist Program, which is supported by Servier Amérique.

PII: S0002-8703(03)00763-4

doi: 10.1016/j.ahj.2003.10.022

American Heart Journal
Volume 148, Issue 1 , Pages 16-26 , July 2004

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