Department of Environmental Medicine, Kyushu University, Fukuoka, Japan.
Hypertens Res. 2009 Dec;32(12):1119-22. doi: 10.1038/hr.2009.161. Epub 2009 Sep 18.
The objective of this paper is to develop a new risk prediction model of cardiovascular disease and to validate its performance in a general population of Japanese. The Hisayama study is a population-based prospective cohort study. A total of 2634 participants aged 40 years or older were followed up for 14 years for incident cardiovascular disease (stroke and coronary heart disease (myocardial infarction, coronary revascularization and sudden cardiac death)). We used data among a random two-thirds (the derivation cohort, n=1756) to develop a new risk prediction model that was then tested to compare observed and predicted outcomes in the remaining one-third (the validation cohort, n=878). A multivariable cardiovascular risk prediction model was developed that incorporated age, sex, systolic blood pressure, diabetes, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and smoking. We assessed the performance of the model for predicting individual cardiovascular event among the validation cohort. The risk prediction model demonstrated good discrimination (c-statistic=0.81; 95% confidence interval, 0.77 to 0.86) and calibration (Hosmer-Lemeshow chi(2)-statistic=6.46; P=0.60). A simple risk score sheet based on the cardiovascular risk prediction model was also presented. We developed and validated a new cardiovascular risk prediction model in a general population of Japanese. The risk prediction model would provide a useful guide to estimate absolute risk of cardiovascular disease and to treat individual risk factors.
本文旨在建立一个新的心血管疾病风险预测模型，并在日本普通人群中验证其性能。平山研究是一项基于人群的前瞻性队列研究。共有 2634 名年龄在 40 岁或以上的参与者随访了 14 年，以观察心血管疾病（中风和冠心病（心肌梗死、冠状动脉血运重建和心脏性猝死））的发生情况。我们使用了三分之二的随机数据（推导队列，n=1756）来建立一个新的风险预测模型，然后在其余的三分之一（验证队列，n=878）中进行测试，以比较观察到的和预测的结果。建立了一个包含年龄、性别、收缩压、糖尿病、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和吸烟的多变量心血管风险预测模型。我们评估了该模型在验证队列中预测个体心血管事件的性能。该风险预测模型表现出良好的区分度（c 统计量=0.81；95%置信区间，0.77 至 0.86）和校准度（Hosmer-Lemeshow χ2 检验统计量=6.46；P=0.60）。还提出了一种基于心血管风险预测模型的简单风险评分表。我们在日本普通人群中建立并验证了一个新的心血管风险预测模型。该风险预测模型将为估计心血管疾病的绝对风险和治疗个体风险因素提供有用的指导。
