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See doi:10.1016/j.ehj.2003.09.002 for the article to which this editorial refersIn their thoughtful and provocative article ‘Are the Framingham and PROCAM coronary heart disease riskfunctions applicable to different European populations? The PRIME Study’, Drs Empana and colleagues astutely conclude that the answer is neither simple nor straightforward.1On the one hand, they conclude that the Framingham (from the United States) and PROCAM (from Germany) risk functions overestimated the absolute risk of coronary heart disease in middle aged men from Belfast (with moderate risk) and France (with low risk). On the other hand, and, of perhaps greater relevance, the Framingham and PROCAM risk functions were able to rank individuals according to their estimated absolute risk.This latter conclusion assumes even greater relevance in light of the historical perspective that the FraminghamRisk Score was promulgated primarily to aid clinicians in making therapeutic decisions by ranking patients according to their estimated absolute risk.2The score …

Global risk assessment for cardiovascular disease and astute clinical judgement