Table 4Risk scoring methods based on the Framingham-Anderson and Wilson models

Framingham-Anderson modificationDescriptionRisk factorsOutcome Prediction periodNotes
Bayly 1999 157Laboratory based computer programAge
Sex
SBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
CHD
10 years
Not applicable to patients with IHD, PVD, genetic hyperlipidaemia or patients on lipid-lowering medication
BHS-IV British Hypertension Society 20047Chart Computer programAge
Sex
Systolic blood pressure
Total cholesterol
HDL cholesterol
Smoking
CVD
10 years
Diabetics assumed to be high risk
Canadian guidelines 1997158NomogramAge
Sex
Total cholesterol (in CVD nomogram)
HDL cholesterol (in CVD nomogram)
Systolic blood pressure
Smoking
Diabetes
LVH
AF (in stroke nomogram)
CVD
Stroke
Carta del rischio cardio-vascolare 2000159ChartsAge
Sex
SBP
Total cholesterol
Smoking
Diabetes
CVD
10 years
Heydtmann 1999160Computer program (download site not now active)Age
Sex
SBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
CVD
Prediction period not specified
Hingorani 1999161Computer programAge
Sex
Systolic blood pressure
Diastolic blood pressure
Antihypertensive treatment
Total cholesterol
HDL cholesterol
Blood glucose
Diabetes
Smoking
LVH
Atrial fibrillation
History of CVD
CHD
Stroke
10 years
Based on Framingham-Anderson and Framingham-Wolf 1991
http://www​.cvhealth.ed.ac.uk/162Web-basedAge
Sex
SBP
DBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
Family history
CHD
10 years
Age >30 years
http://www​.healing-hearts.net/risk.html163Web-basedAge
Sex
SBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
CHD
10 years
http://www​.med-decisions​.com/cvtool/active​/provider/provider.html164Web-basedAge
Sex
SBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
CHD
4–12 years
Ages 30–75 with no history of CVD
US resident
Joint British recommendations 19983
Cardiac Risk Assessor165
Chart Computer programAge
Sex
Systolic or diastolic blood pressure
Total cholesterol
HDL cholesterol
Smoking
Diabetes
Family history
CHD (coronary death or non fatal MI)
10 years
Family history and Indian ethnic group adjustment suggested.
Not applicable in patients with familial hypercholesterolaemia or renal dysfunction
Age 30–70
Joint British recommendations modified 2000166Chart Computer programAge
Sex
Systolic or diastolic blood pressure
Total cholesterol
HDL cholesterol
Smoking
Diabetes
Family history
CHD (coronary death or non fatal MI)
10 years
Age 30–74
Joint European Societies recommendations 19945ChartsAge
Sex
Systolic blood pressure
Smoking
Total cholesterol
CHD
10 years
Joint European Societies Second Joint Task Force on Coronary Prevention 1998167ChartsAge
Sex
Systolic blood pressure
Total cholesterol
Smoking
Diabetes
CHD (coronary death, non-fatal MI, angina pectoris)
10 years
HDL set at 1.0mmol/L for men and 1.1mmol/L for women
New Zealand charts 1993168Charts and risk factor countingAge
Sex
Systolic or diastolic blood pressure
Risk factor counting 0–3 (smoking, diabetes, cholesterol/HDL ratio >6.1, BMI >30, family history of CVD)
CVD
5 years
New Zealand charts 19962;169ChartsAge
Sex
Systolic or diastolic blood pressure
Total cholesterol
HDL cholesterol
Smoking
Diabetes
CVD
5 years
Also consider BMI, hyperlipidaemia and family history of CVD. If CVD present patient is in high risk group
New Zealand charts 2003170ChartsAge
Sex
Total cholesterol
HDL cholesterol
Systolic or diastolic blood pressure
Smoking
Diabetes
CVD
5 years
Suggests adjustments for ethnic group, family history, microalbuminuria, duration and severity of diabetes and metabolic syndrome)
New Zealand charts updated 2000171ChartsAge
Sex
Systolic or diastolic blood pressure
Total cholesterol
HDL cholesterol
Smoking
Diabetes
CVD (major events)
5 years
Not for use age >70
Authors note importance of family history and physical inactivity
PCV-METRA modification Laurier 199453EquationAge
Sex
SBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
CHD
6 years
Recalibration for French population
Rabindrath172Laboratory based computer programAge
Sex
SBP
Total cholesterol
HDL cholesterol
Smoking
Diabetes
LVH
CHD 10 years
Sheffield tables 1995173TablesAge
Sex
Total cholesterol
Hypertension
Smoking
Diabetes
LVH
Coronary deathHDL set at 1.15mmol/L for men and 1.40mmol/L for women
Sheffield tables new 2000174
Sheffield tables 1997175
TablesAge
Sex
Total cholesterol
HDL cholesterol
Hypertension
Smoking
Diabetes
LVH
CHD
10 years
Sheffield tables updated 1996176TablesAge
Sex
Total cholesterol
Hypertension
Smoking
Diabetes
LVH
CHDIdentifies patients with estimated risk of CHD of less than or greater than 3.0%/year
WHO/ISH 1999177
WHO/ISH 2003178
Chart incorporating risk factor countingHypertension (JNC VI)
Total cholesterol
Smoking
Diabetes
Family history of CVD
Target organ damage
Associated clinical conditions
CVD (cardiovascular death, non fatal MI, non fatal stroke)Applicable to men age >55 and women >65
Yudkin 1999179ChartsAge
Sex
Systolic blood pressure
Total cholesterol
HDL cholesterol
Smoking
Diabetes
Microalbuminuria
CHD (CHD death, MI or angina pectoris)Separate charts for normoalbuminuric and microalbuminuric diabetic and non-diabetic men and women
Framingham-Anderson modification: othersDescription
Aarabi 2005180Adjustment factor for total cholesterol: HDL cholesterol ratio for use in South Asians
Becht 2002181Computer program
Birmingham Heartlands Calculator 157Computer program with graph output
Bonneux 2000182Life table
Cardiorisk manager (BMJ Books 1999)183Computer program
Carroll 2002184Computer program with risk displayed as “risk thermometer”
El Programa de Actividades Preventivas y de Promoción de la Salud 2003185Table
EMIS186Computer program
EsPeR. Colombet 2003187Incorporation in clinical decision aid
Forge 2001188Web-based or computer program
Global Diabetes Model189Risk equation
Heartcheck190Physician/patient workbook
HjerterRask http://www​.hjerterrask.dk/default.php191Computer program
http://www​.ministerosalute.it/192Risk chart
Lemieux 2001193Equation incorporating insulin, Apo B, small LDL size
Medcal Risk CHD (also includes Dundee score)194Computer program
The Danish College of General Practitioners 1998195Guidelines
Ulrich 2000196 Also incorporates Wolf 1991 stroke functionLife table
Van der Meer 2003 197Equation (option of including CRP)
Vergara 2000198Computer program
Framingham-Wilson modificationDescription
American Heart Association Multiple Risk FactorRisk equation
Assessment Equation199Points assigned for impaired fasting glucose (110–126 mg/dl)
Ferrucci 2001200Point score
One extra point for age ≥75 years
Fodor 2000201 Canadian guidelinesTable
Grundy 2001202. Based on NCEP (ATPIII)Age replaced with coronary calcium
http://www​.americanheart​.org/presenter.jhtml?identifier​=3003500&​_requestid=1263683203Web-based
http://www​.nhlbi.nih​.gov/about/framingham/riskabs.htm204Tables
Marrugat 2003101Recalibration for Spanish population
Framingham-Anderson modification: othersDescription
NCEP ATPIII3Chart
Table
http://www​.nhlbi.nih​.gov/guidelines/cholesterol/index.htm205Computer program, web-based
Ridker 2002206Includes hsCRP in risk equation
STAT Cholesterol http://www​.statcoder.com/cholesterol.htm207Computer program

From: Risk scoring methods designed to identify people at high risk of cardiovascular disease

Cover of A Systematic Review of Risk Scoring Methods and Clinical Decision Aids Used in the Primary Prevention of Coronary Heart Disease (Supplement)
A Systematic Review of Risk Scoring Methods and Clinical Decision Aids Used in the Primary Prevention of Coronary Heart Disease (Supplement) [Internet].
NICE Clinical Guidelines, No. 67S.
Beswick AD, Brindle P, Fahey T, et al.
Copyright © 2008, Royal College of General Practitioners.

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