title: [Coronary risk estimation in Spain using a calibrated Framingham function].
abstract: OBJECTIVE
  The Framingham coronary heart disease (CHD) functions overestimate the risk of CHD in countries with a low incidence. Consequently, these functions should be calibrated for the purpose of primary prevention. Calibrated Framingham function charts of overall CHD risk for the Spanish population are presented. Patients and methods. The Framingham functions were calibrated by substituting the prevalence of CHD risk factors and incidence found in Framingham with the same values for Spain. The Framingham function that included high-density lipoprotein (HDL) cholesterol was used. The 10-year probability of developing a CHD event was estimated for several combinations of risk factors and HDL levels ranging from 35 to 59 mg/dl. Color-coded charts were prepared that show the exact probability of CHD corresponding to each combination of risk factors, shown in separate cells on the chart.
  
  
  RESULTS
  The event rate and prevalence of CHD risk factors differed considerably between Girona and Framingham. HDL < 35 mg/dL increased risk by approximately 50% and HDL > 60 mg/dL reduced it by 50%. The proportion of cells in which the 10-year probability of developing a CHD event was > 9% was 2.3 times higher and that of cells with a probability > 19% was 13 times lower in the chart calibrated for Spain than in the original Framingham charts.
  
  
  CONCLUSIONS
  The calibrated Framingham function may help to more accurately estimate the overall risk of CHD in the Spanish population for primary prevention purposes. The calibrated function should be validated, and the development of functions for the Spanish population should be promoted.
authors.affiliation: Unitat de Lípids i Epidemiologia Cardiovascular. Institut Municipal d'Investigació Mèdica (IMIM). Barcelona. Universitat Autònoma de Barcelona. Spain. jmarrugat@imim.es
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: Pascual
authors.initials: P
authors.lastname: Solanas
authors.forename: Ralph
authors.initials: R
authors.lastname: D'Agostino
authors.forename: Lisa
authors.initials: L
authors.lastname: Sullivan
authors.forename: José
authors.initials: J
authors.lastname: Ordovas
authors.forename: Ferran
authors.initials: F
authors.lastname: Cordón
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramos
authors.forename: Joan
authors.initials: J
authors.lastname: Sala
authors.forename: Rafael
authors.initials: R
authors.lastname: Masià
authors.forename: Izabella
authors.initials: I
authors.lastname: Rohlfs
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
authors.forename: William B
authors.initials: WB
authors.lastname: Kannel
mesh_terms: D000465:Algorithms; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology