The Framingham Heart Study
Recurring Coronary Heart Disease
(based on D'Agostino, Russell MW, Huse DM et al. 'Primary and subsequent coronary risk appraisal: new results from the Framingham Study', American Heart Journal 2000)
Outcome
Subsequent CHD (includes mostly hospitalized events consisting of myocardial infarction, coronary insufficiency, angina pectoris, and sudden and non-sudden coronary death)
Duration of follow-up
Maximum of 4 years, 2-year risk prediction
Population of interest
Individuals who had at least one CHD event or ischemic stroke before examination and survived the acute stage of that event.
Predictors
  • Age
  • Systolic blood pressure (SBP)
  • Cigarette smoking status (1 if current smoker, 0 otherwise)
  • Fasting lipid level (total and HDL cholesterol)
  • Physician diagnosis of diabetes at the current or a previous examination
Men: 2-year risk of recurring CHD
Age Points
35 - 39 0
40 - 44 1
45 - 49 3
50 - 54 4
55 - 59 6
60 - 64 7
65 - 69 9
70 - 74 10
HDL-C
Total-C 25 30 35 40 45 50 60 70 80
160 10 9 7 6 5 4 3 1 0
170 11 9 8 7 6 5 3 2 1
180 11 10 8 7 6 5 4 2 1
190 12 10 9 8 7 6 4 3 2
200 12 11 9 8 7 6 5 3 2
210 13 11 10 9 7 7 5 4 2
220 13 11 10 9 8 7 5 4 3
230 13 12 10 9 8 7 6 4 3
240 14 12 11 10 9 8 6 5 4
250 14 13 11 10 9 8 6 5 4
260 15 13 12 10 9 8 7 5 4
270 15 13 12 11 10 9 7 6 5
280 15 14 12 11 10 9 7 6 5
290 16 14 13 11 10 9 8 6 5
300 16 14 13 12 11 10 8 7 6
Diabetes
No 0
Yes 4
Pts 2-yr
Probabilities
Pts 2-yr
Probabilities
Pts 2-yr
Probabilities
0 3% 14 9% 28 25%
2 4% 16 11% 30 29%
4 4% 18 13%
6 5% 20 14%
8 6% 22 17%
10 7% 24 19%
12 8% 26 22%
Women: 2-year risk of recurring CHD
Age Points
35 - 39 0
40 - 44 1
45 - 49 2
50 - 54 3
55 - 59 4
60 - 64 5
65 - 69 6
70 - 74 7
HDL-C
Total-C 25 30 35 40 45 50 60 70 80
160 10 9 7 6 5 4 3 1 0
170 11 9 8 7 6 5 3 2 1
180 11 10 8 7 6 5 4 2 1
190 12 10 9 8 7 6 4 3 2
200 12 11 9 8 7 6 5 3 2
210 13 11 10 9 8 7 5 4 2
220 13 12 10 9 8 7 5 4 3
230 14 12 11 9 8 7 6 4 3
240 14 12 11 10 9 8 6 5 4
250 14 13 11 10 9 8 7 5 4
260 15 13 12 11 9 9 7 6 4
270 15 13 12 11 10 9 7 6 5
280 15 14 12 11 10 9 8 6 5
290 16 14 13 12 10 10 8 7 5
300 16 14 13 12 11 10 8 7 6
Diabetes Cigs
No 0 No 0
Yes 3 Yes 4
SBP
<110 0
110-114 1
115-124 3
125-134 4
135-144 5
145-154 6
155-164 7
165-184 8
185-194 9
195-214 10
215-224 11
225-244 12
245+ 13
Pts 2-yr
Probabilities
Pts 2-yr
Probabilities
Pts 2-yr
Probabilities
0 1% 14 3% 28 9%
2 1% 16 3% 30 11%
4 1% 18 4% 32 13%
6 1% 20 5% 34 16%
8 2% 22 5% 36 19%
10 2% 24 7% 38 22%
12 2% 26 8%
Weibull Regression coefficients for direct estimation of risk of subsequent CHD event
Variable Men Women
Intercept 4.995 13.537
Age 0.0145 -0.0225
In (total cholesterol/HDL) 0.6738 -0.834
In (SBP) - -1.3713
Diabetes 0.3042 -0.7829
Smoker - -0.3669
Extreme Value Parameter 0.9994 1.0313