title: Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: the FRESCO Study.
abstract: OBJECTIVE
  To derive and validate a set of functions to predict coronary heart disease (CHD) and stroke, and validate the Framingham-REGICOR function.
  
  
  METHODS
  Pooled analysis of 11 population-based Spanish cohorts (1992-2005) with 50,408 eligible participants. Baseline smoking, diabetes, systolic blood pressure (SBP), lipid profile, and body mass index were recorded. A ten-year follow-up included re-examinations/telephone contact and cross-linkage with mortality registries. For each sex, two models were fitted for CHD, stroke, and both end-points combined: model A was adjusted for age, smoking, and body mass index and model B for age, smoking, diabetes, SBP, total and HDL cholesterol, and for hypertension treatment by SBP, and age by smoking and by SBP interactions.
  
  
  RESULTS
  The 9.3-year median follow-up accumulated 2973 cardiovascular events. The C-statistic improved from model A to model B for CHD (0.66 to 0.71 for men; 0.70 to 0.74 for women) and the combined CHD-stroke end-points (0.68 to 0.71; 0.72 to 0.75, respectively), but not for stroke alone. Framingham-REGICOR had similar C-statistics but overestimated CHD risk.
  
  
  CONCLUSIONS
  The new functions accurately estimate 10-year stroke and CHD risk in the adult population of a typical southern European country. The Framingham-REGICOR function provided similar CHD prediction but overestimated risk.
authors.affiliation: Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain. Electronic address: jmarrugat@imim.es.
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.affiliation: Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Isaac
authors.initials: I
authors.lastname: Subirana
authors.affiliation: Unitat de Recerca d'Atenció Primària, Instituto de Investigación en Atención Primaria Jordi Gol. Instituto de Investigación de Girona, Spain.
authors.forename: Rafel
authors.initials: R
authors.lastname: Ramos
authors.affiliation: Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Vila
authors.affiliation: Centro de Salud San José Norte, Zaragoza, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Marín-Ibañez
authors.affiliation: Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain; Servicio de Investigación, Innovación y Formación, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Guembe
authors.affiliation: Grupo Cardiovascular de Baleares de la REDIAP IBSALUT, Palma de Mallorca, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rigo
authors.affiliation: CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Tormo Díaz
authors.affiliation: CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain; Instituto de Salud Pública de Navarra, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain.
authors.forename: Conchi
authors.initials: C
authors.lastname: Moreno-Iribas
authors.affiliation: Unitat de Recerca d'Atenció Primària, Institut Català de la Salut, Tarragona-Reus, Spain.
authors.forename: Joan Josep
authors.initials: JJ
authors.lastname: Cabré
authors.affiliation: Instituto de Ciencias de la Salud, Consejería de Salud y Asuntos Sociales, Junta de Comunidades de Castilla - La Mancha, Talavera de la Reina, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Segura
authors.affiliation: Centro de Atención Primaria La Marina, IDIAP Jordi Gol, Barcelona, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Baena-Díez
authors.affiliation: CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Unidad de Investigación Clínica, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Agustín Gómez
authors.initials: AG
authors.lastname: de la Cámara
authors.affiliation: Centro de Salud Universitario "San Pablo", Distrito Sanitario Atención Primaria Sevilla, Servicio Andaluz de Salud, Sevilla, Spain; CIBER de Fisiopatología de la Obesidad y la Nutrición, CIBEROBN FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.affiliation: Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Grau
authors.affiliation: Unitat de Recerca d'Atenció Primària, Instituto de Investigación en Atención Primaria Jordi Gol. Instituto de Investigación de Girona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Quesada
authors.affiliation: Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Madrid, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Medrano
authors.affiliation: Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain.
authors.forename: Paulino
authors.initials: P
authors.lastname: González Diego
authors.affiliation: Grupo Cardiovascular de Baleares de la REDIAP IBSALUT, Palma de Mallorca, Spain.
authors.forename: Guiem
authors.initials: G
authors.lastname: Frontera
authors.affiliation: CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Gavrila
authors.affiliation: CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Grupo de Investigación Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Spain; Instituto de Salud Pública de Navarra, Departamento de Salud, Gobierno de Navarra, Pamplona, Spain.
authors.forename: Eva Ardanaz
authors.initials: EA
authors.lastname: Aicua
authors.affiliation: Unitat de Recerca d'Atenció Primària, Institut Català de la Salut, Tarragona-Reus, Spain; CIBER de Fisiopatología de la Obesidad y la Nutrición, CIBEROBN FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Basora
authors.affiliation: Instituto de Ciencias de la Salud, Consejería de Salud y Asuntos Sociales, Junta de Comunidades de Castilla - La Mancha, Talavera de la Reina, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: García
authors.affiliation: Centro de Atención Primaria La Marina, IDIAP Jordi Gol, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: García-Lareo
authors.affiliation: Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Gutierrez
authors.affiliation: CIBER de Fisiopatología de la Obesidad y la Nutrición, CIBEROBN FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain; Plan Integral de Diabetes de Andalucía, Servicio Andaluz de Salud, Sevilla, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mayoral
authors.affiliation: Department of Cardiology, Hospital Universitari Dr. Josep Trueta, Girona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Sala
authors.affiliation: Framingham Heart Study, Boston University, Boston, MA, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: D'Agostino
authors.affiliation: Research Group on Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP FEDER-ERDF Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012042:Registries; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis
chemical_list: D008076:Cholesterol, HDL
keywords: Cardiovascular diseases; Coronary disease; Prevention; Risk functions; Stroke