title: Original and REGICOR Framingham functions in a nondiabetic population of a Spanish health care center: a validation study.
abstract: OBJECTIVE
  Risk functions can help general practitioners identify patients at high cardiovascular risk, but overprediction inevitably leads to a disproportionate number of patients being targeted for treatment. To assess predicted cardiovascular risk, we analyzed the 10-year performance of the original and REGICOR Framingham coronary risk functions in nondiabetic patients.
  
  
  METHODS
  Ours was a longitudinal, observational study of a retrospective cohort of patients observed for 10 years in primary care practices in Badajoz, Spain. Our cohort comprised 447 nondiabetic patients aged 35 to 74 years who had no evidence of cardiovascular disease and were not on lipid-lowering or antihypertensive therapy. We assessed the patients' 10-year coronary risk measurement from the time of their recruitment. We also estimated the percentage of patients who were candidates for antihypertensive and lipid-lowering therapy.
  
  
  RESULTS
  The actual incidence rate of coronary events was 6.7%. The original Framingham equation overpredicted risk by 73%, whereas the REGICOR Framingham function underpredicted risk by 64%. The Brier scores were 0.06364 and 0.06093 (P = .365) for the original Framingham and REGICOR Framingham functions, respectively, and the remaining discrimination and calibration parameters were also highly similar for both functions. The original Framingham function classified 14.8% of the population as high risk and the REGICOR Framingham function classified 6.9%. The proportions of patients who, according to the original Framingham and REGICOR functions, would be candidates for lipid-lowering therapy were 14.3% and 6.7%, and for antihypertensive therapy they were 12.5% and 7.8%, respectively.
  
  
  CONCLUSIONS
  The original Framingham equation overestimated coronary risk whereas the REGICOR Framingham function underestimated it. The original Framingham function selected a greater percentage of candidates for antihypertensive and lipid-lowering therapy.
authors.affiliation: Centro de Salud Universitario La Paz, Unidad Docente de Medicina Familiar y Comunitaria, Avda. República Dominicana, Badajoz, Spain. fbuitragor@meditex.es
authors.forename: Francisco
authors.initials: F
authors.lastname: Buitrago
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Calvo-Hueros
authors.forename: Lourdes
authors.initials: L
authors.lastname: Cañón-Barroso
authors.forename: Gerónimo
authors.initials: G
authors.lastname: Pozuelos-Estrada
authors.forename: Luis
authors.initials: L
authors.lastname: Molina-Martínez
authors.forename: Manuel
authors.initials: M
authors.lastname: Espigares-Arroyo
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Galán-González
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Lillo-Bravo
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents