Prospective Validation of Framingham Criteria for Congestive Heart Failure Diagnosis in a High-Altitude Population

Abstract

"altitude." This we find pivotal because the organism of high altitude residents going down to sea level, has to adapt to the "relative hyperoxic environment." It is wrongly assumed that for high altitude residents, going to a lower altitude where there is more oxygen pressure, as a result of a higher barometric pressure, is beneficial. We strongly question this, as high altitude residents, being born, developed, and carrying out normal lives in the mountain cities of the world living in perfect harmony with our environment. We, as Andean high altitude residents, have higher hematocrit and hemoglobin values, as the fundamental compensating biological response. All living beings, humans, animals and plants and presumably other microscopic organisms suffer biologic changes on barometric pressure changes. In other words, physical changes in the environment, induce biological changes. The rules governing physics are imbedded within biology. The formula of adaptation is not only useful for high altitude adaptation, but rather can be used for any type of adaptation, where the organism in order to survive, needs to find the most energy efficient, fastest rebuild or healing process of the organic systems. An example can be found with a wound in the skin. When the two borders are sutured, the healing process takes around 1 week. This would be: healing adaptation ¼ time/tissue. This formula changes in time if the tissue is skin or bone, the later requiring a longer time of a few months. This formula also varies with age, taking longer for the older people: Adaptation to healing ¼ time/age. It should be well understood, that the healthier the subject, the better the adaptation. But it also applies to allergic reactions to mosquito bites in those not habituated to them in comparison to those living in those areas. Likewise, a viral aggression like flu, has a latent period of immunity that follows the same rule: Adaptation to viral aggression ¼ time/type of viral agent. This formula has other additional variables like nutrition, stress and aggressiveness of the viral agent. Furthermore it also applies to adaptation to smell. When a new perfume is smelled for the first time it is very strong, but persistent use of it changes the capacity of sensing it: Adaptation to smell ¼ time/scent. Muscle adaptation to exercise also follows the same formula: Adaptation to exercise ¼ time/exercise Δ. The more exercise, the greater the hypertrophy of the muscles and vice-versa. In conclusion the Adaptation Formula is a fundamental formula that applies to all biological adaptation processes in the multiple survival mechanisms of all living beings, and can be generalized as: Adaptation ¼ time/change.

Practice patterns in the management of congestive heart failure and post-discharge quality of life: A hospital-based cross-sectional study

“…The Framingham criteria is widely used in the diagnosis of CHF. [ 12 ] The Framingham Criteria has been independently validated to have 90–100% sensitivity in the clinical diagnosis of patients with heart failure [ 13 14 15 16 ] with variable specificity. To the author's knowledge, there have been no prior studies in evaluating the prevalence of various components of the Framingham Criteria in patients diagnosed with CHF.…”