Using the Framingham model to predict heart disease in the United Kingdom: retrospective study

Abstract

Editorial by Jackson Guidelines on the use of drugs to lower serum concentrations of lipids to prevent coronary heart disease target treatment to patients who have a high absolute risk of the disease. Although a patient's absolute risk of heart disease can be derived using risk tables1 —for example, the Sheffield table—these are based on the Framingham model which may not be applicable to the population in the United Kingdom.2 We aimed to determine whether the Framingham model accurately predicts the risk of coronary heart disease among white men and women in the United Kingdom. A cross section of the population of Whickham, north east England, was enrolled in a study of ischaemic heart disease between 1972 and 1974 and followed up 20 years later.3 At baseline, data was collected on body mass index, family history of coronary heart disease, fasting glucose concentrations, and triglyceride concentrations. Standardised WHO questionnaires on chest pain were administered, and the information necessary to complete the Framingham model (age, sex, systolic blood pressure, ratio of total cholesterol to high density lipoprotein cholesterol, presence of left ventricular hypertrophy, presence of diabetes, and smoking habits4 was also collected, with the exception of concentrations of …