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Simplified heart-risk guideline may miscalculate risk for millions
Date:9/9/2010

A method that is widely used to predict the risk of a major coronary event may over- or underestimate risk for millions of Americans, according to a study directed by a researcher at the San Francisco VA Medical Center and the University of California, San Francisco.

The method in question is the simplified version of the so-called Framingham model, which is used to estimate a patient's 10-year risk of a heart attack, stroke, or other coronary event based on risk factors such as age, cholesterol levels, blood pressure, and smoking. National guidelines recommend using the risk estimates generated by the Framingham model to classify patients as among one of three risk groups. Guidelines recommend more aggressive strategies to treat cholesterol in patients classified into higher-risk groups.

The original Framingham model uses a complicated mathematical equation to calculate risk, while the simplified version is based on a point system, with a certain number of points for each risk factor.

"We thought there might be significant differences between the two methods, which would have significant impacts on how people are treated for cholesterol," says principal investigator Michael Steinman, MD, a physician at SFVAMC and an assistant professor of medicine at UCSF. "And in fact, that turned out to be the case."

For the study, which appears in the Online First section of the "Journal of General Internal Medicine," the researchers assessed data from 2,543 subjects who participated from 2001 to 2006 in National Health and Nutrition Examination Surveys sponsored by the Centers for Disease Control and Prevention. The subjects were chosen to be representative of 39 million adults in the United States for whom guidelines recommend using the Framingham method to predict future cardiovascular risk.

For each subject, the researchers calculated risk based on the original Framingham model and on the simplified model, and comp
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Contact: Kristen Bole
kristen.bole@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert

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