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Risk functions for prediction of cardiovascular disease in elderly Australians: the Dubbo Study
Author(s) -
Simons Leon A,
Simons Judith,
Palaniappan Latha,
Friedlander Yechiel,
McCallum John
Publication year - 2003
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2003.tb05100.x
Subject(s) - medicine , framingham risk score , diabetes mellitus , myocardial infarction , incidence (geometry) , framingham heart study , cohort , cohort study , prospective cohort study , disease , physical therapy , cardiology , endocrinology , physics , optics
Objectives: To evaluate a Framingham risk function for coronary heart disease in an elderly Australian cohort and to derive a risk function for cardiovascular disease (CVD) in elderly Australians. Design and setting: Analysis of data from a prospective cohort study (the Dubbo Study) in a semi‐urban town (population, 34 000). Participants: 2805 men and women 60 years and older living in the community, first assessed in 1988, and a subcohort of 2102 free of CVD at study entry. Main outcome measures: Incidence of CVD (myocardial infarction, coronary death or stroke) over 5 and 10 years. Results: A Framingham risk function assessing “hard” coronary heart disease (ie, myocardial infarction or coronary death) accurately predicted 10‐year incidence in men and women aged 60–79 years who were free of prevalent CVD or diabetes at study entry. In a multiple logistic model, CVD incidence was significantly predicted by age, sex, taking antihypertensive medication, blood pressure, smoking, total cholesterol level and diabetes. For a given age and cholesterol level, CVD risk over 5 years was doubled in the presence of antihypertensive medication or diabetes, increased by 50% with cigarette smoking, and halved in women compared with men. Conclusions: We have derived a simple CVD risk function specifically for elderly Australians that employs risk factors readily accessible to all medical practitioners.