title: The population effects of the global cardiovascular risk model in United States adults: findings from the National Health and Nutrition Surveys, 2005-2006.
abstract: BACKGROUND
  The Framingham Global Cardiovascular Disease (FRS-CVD) risk assessment is a proposed alternative for the assessment of hard coronary heart disease (FRS-CHD) event risk. Beyond heart attack and death, FRS-CVD risk adds the end points of cerebrovascular disease, angina, heart failure, and peripheral vascular disease.
  
  
  OBJECTIVE
  We sought to estimate the population impact of using FRS-CVD instead of FRS-CHD risk prediction on U.S. adults.
  
  
  METHODS
  We analyzed FRS-CHD and FRS-CVD risk in men age 45-74 and women age 55-74 without cardiovascular disease or diabetes, using the National Health and Nutrition Examination Survey 2005-2006. We stratified the population into 10-year risk categories: low: <6%, moderate ≥ 6 to <10%, moderate high ≥ 10 to <20%, and high ≥ 20% by both risk models, and assessed change in risk category distribution and achievement of lipid goals.
  
  
  RESULTS
  We analyzed 1020 subjects who statistically represent approximately 50 million U.S. adults. When the FRS-CVD was used, we found that 63% of men and 74% of women increase at least one risk category compared with when the FRS-CHD is used. Overall, the low-risk population decreases from 52% to 16% and the high-risk group increases from 4% to 20%. Of the subjects changing risk categories, 30% will now fail to meet their new corresponding lipid goals.
  
  
  CONCLUSIONS
  FRS-CVD end points are more comprehensive, yet the population implications of such a change may be profound. The use of a FRS-CVD risk model significantly increases the intermediate and high-risk groups, thus increasing the number of individuals eligible for novel risk assessment tools such as high-sensitivity C-reactive protein, coronary calcium scoring, and more frequent use of pharmacotherapy.
authors: Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, MC 3248, Madison, WI 53792, USA.
authors: Matthew C
authors: MC
authors: Tattersall
authors: Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, MC 3248, Madison, WI 53792, USA.
authors: Kunal N
authors: KN
authors: Karmali
authors: Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors: Ronald E
authors: RE
authors: Gangnon
authors: Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, MC 3248, Madison, WI 53792, USA. Electronic address: jgk@medicine.wisc.edu.
authors: Jon G
authors: JG
authors: Keevil
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