Primary Prevention of Coronary Heart Disease: Guidance From Framingham

Grundy, Scott M.; Balady, Gary J.; Criqui, Michael H.; Fletcher, Gerald F.; Greenland, Philip; Hiratzka, Loren F.; Houston-Miller, Nancy; Kris‐Etherton, Penny M.; Krumholz, Harlan M.; LaRosa, John C.; Ockene, Ira S.; Pearson, Thomas A.; Reed, James W.; Washington, Reginald L.; Smith, Sidney C.

doi:10.1161/01.cir.97.18.1876

Cited by 511 publications

(189 citation statements)

References 147 publications

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“…There is substantial evidence from several large-scale, prospective, longitudinal studies, such as the Framingham Heart Study (Grundy et al, 1998), Diabetes Prevention Program (Diabetes Prevention Program Research Group, 2002), Multiple Risk Factor Intervention Trial (Leon et al, 1997), and the Nurses' Health Study (Stampfer et al, 2000), that improving dietary habits and/or increasing physical activity can effectively reduce risks for developing cardiovascular diseases and type 2 diabetes, thereby enhancing overall health. Exercise also provides psychological benefits and enhances quality of life (LaCroix et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Worksite Opportunities for Wellness (WOW): Effects on cardiovascular disease risk factors after 1 year

Racette¹,

Deusinger²,

Inman³

et al. 2009

Preventive Medicine

111

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Objective-To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors. overweight/obese) participated in a cohort-randomized trial comparing assessments + intervention (worksite A) with assessments only (worksite B) for 1 year. All participants received personal health reports containing their assessment results. The intervention was designed to promote physical activity and favorable dietary patterns using pedometers, healthy snack cart, WeightWatchers® meetings, group exercise classes, seminars, team competitions, and participation rewards. Outcomes included BMI, body composition, blood pressure, fitness, lipids, and Framingham 10-year coronary heart disease risk. Methods-InResults-123 participants, aged 45 ± 9 yr, with BMI 32.9 ± 8.8 kg/m 2 completed 1 year. Improvements (P ≤ 0.05) were observed at both worksites for fitness, blood pressure, and total-, HDL-, and LDL-cholesterol. Additional improvements occurred at worksite A in BMI, fat mass, Framingham risk score, and prevalence of the metabolic syndrome; only the changes in BMI and fat mass were different between worksites.Conclusion-A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors, but many of the improvements were achieved with worksite health assessments and personalized health reports in the absence of an intervention.

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Section: Introductionmentioning

confidence: 99%

Worksite Opportunities for Wellness (WOW): Effects on cardiovascular disease risk factors after 1 year

Racette¹,

Deusinger²,

Inman³

et al. 2009

Preventive Medicine

111

View full text Add to dashboard Cite

show abstract

“…The prevention of cardiovascular diseases is now targeted for the reduction of the overall absolute risk of the disease [1, 2,3,4], taking into account a number of risk factors. Various risk scores have been developed to estimate the risk of a coronary or a cardiovascular event (or mortality) within a given time frame in those without cardiovascular disease at baseline.…”

Section: Introductionmentioning

confidence: 99%

Prediction of the risk of cardiovascular mortality using a score that includes glucose as a risk factor. The DECODE Study

Balkau

Hu²,

Qiao³

et al. 2004

Diabetologia

139

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Aims/hypothesis. Risk scores have been developed to predict cardiovascular or coronary risk, and while most have included diabetes as a risk factor, none have included lower glucose concentrations, either at fasting or following a 2-h oral glucose tolerance test. This article develops 5-and 10-year risk scores for cardiovascular mortality that include glucose concentrations as well as known diabetes status. Methods. Data is from the DECODE cohort: 16,506 men and 8,907 women from 14 European studies. The risk factors studied were as follows: age, fasting and 2-h glucose (including cases of known diabetes), fasting glucose alone (including cases of known diabetes), cholesterol, smoking status, systolic blood pressure and BMI. For an absolute risk score the 1995 countryand sex-specific cardiovascular death rates were used. Results. In men, for both 5-and 10-year cardiovascular mortality, after adjusting for age and study centre, all studied risk factors, except BMI, were significantly associated with cardiovascular mortality (p<0.05). These results were unchanged in multivariate models with all factors included. In women, after adjusting for age and centre, glucose categories, systolic blood pressure and BMI were predictive of 5-year cardiovascular mortality. With all factors in the model, only age and glucose categories were predictive. In terms of 10-year cardiovascular mortality, smoking status and blood pressures were also predictive in the women. For men and women, the same scores were used for the risk factors, except for age and glucose categories where the hazard ratios differed significantly. Conclusions/interpretation. Including glucose concentrations as well as diabetic status provides quantitative information on cardiovascular risk prediction.

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“…The Framingham risk score remains the most widely used tool for assessment of risk prediction of CV events [23]. Conventional risk factors in the Framingham risk score such as age, male sex, hypercholesterolemia, hypertension, and smoking, account for most of the risk of CVD and have been the basis of risk assessment for decades.…”

Section: Discussionmentioning

confidence: 99%

A score including ADAM17 substrates correlates to recurring cardiovascular event in subjects with atherosclerosis

et al. 2015

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a b s t r a c tObjective: Atherosclerosis disease is a leading cause for mortality and morbidity. The narrowing/rupture of a vulnerable atherosclerotic plaque is accountable for acute cardiovascular events. However, despite of an intensive research, a reliable clinical method which may disclose a vulnerable patient is still unavailable.Approach and results: We tested the association of ADAM17 (A Disintegrin and Metallo Protease Domain 17) circulating substrates (sICAM-1, sVCAM-1, sIL6R and sTNFR1) with a second major cardiovascular events [MACEs] (cardiovascular death, peripheral artery surgeries, non-fatal myocardial infarction and non-fatal stroke) in 298 patients belonging to the Vascular Diabetes (AVD) study. To evaluate ADAM17 activity we create ADAM17 score through a RECPAM model. Finally we tested the discrimination ability and the reclassification of clinical models. At follow-up (mean 47 months, range 1e118 months), 55 MACEs occurred (14 nonfatal MI, 14 nonfatal strokes, 17 peripheral artery procedures and 10 cardiovascular deaths) (incidence ¼ 7.8% person-years). An increased risk for incident events was observed among the high ADAM17 score individuals both in univariable (HR 19.20, 95% CI 15.82e63.36, p < 0.001) and multivariable analysis (HR 3.42, 95% CI 1.55 e7.54, p < 0.001). Finally we found that ADAM17 score significantly increases the prediction accuracy of the Framingham Recurring-Coronary-Heart-Disease-Score, with a significant improvement in discrimination (integrated discrimination improvement ¼ 9%, p ¼ 0.012) and correctly reclassifying 10% of events and 41% of non-events resulting in a cNRI ¼ 0.51 (p ¼ 0.005). Conclusion: We demonstrated a positive role of ADAM17 activity to predicting CV events. We think that an approach that targets strategies beyond classic cardiovascular risk factors control is necessary in individuals with an established vascular atherosclerosis.

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Primary Prevention of Coronary Heart Disease: Guidance From Framingham

Cited by 511 publications

References 147 publications

Worksite Opportunities for Wellness (WOW): Effects on cardiovascular disease risk factors after 1 year

Worksite Opportunities for Wellness (WOW): Effects on cardiovascular disease risk factors after 1 year

Prediction of the risk of cardiovascular mortality using a score that includes glucose as a risk factor. The DECODE Study

A score including ADAM17 substrates correlates to recurring cardiovascular event in subjects with atherosclerosis

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