Setayeshgar Solmaz, Whiting Susan J, Pahwa Punam, Vatanparast Hassanali
a Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
b Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
Appl Physiol Nutr Metab. 2015 Oct;40(10):1068-74. doi: 10.1139/apnm-2015-0074. Epub 2015 Jul 8.
Initial risk assessment to estimate 10-year risk of cardiovascular disease (CVD) is completed by Framingham Risk Score (FRS). In 2012 2 modifications were added to FRS by the Canadian Cardiovascular Society: FRS is doubled in subjects aged 30-59 years who have CVD present in a first-degree relative before 55 years of age for men and 65 years of age for women; and cardiovascular age is calculated for each individual. Our aim was to implement these modifications and evaluate differences compared with traditional FRS. Further, we evaluated the association between dietary intake and 10-year risk. The Canadian Health Measures Survey data cycle 1 was used among participants aged 30-74 years (n = 2730). Descriptive and logistic regression analyses were conducted using STATA SE 11. Using modified FRS for predicting 10-year risk of CVD significantly increased the estimated risk compared with the traditional approach, 8.66% ± 0.35% versus 6.06% ± 0.18%, respectively. Greater impact was observed with the "cardiovascular age" modification in men versus women. The distribution of Canadians in low- (<10%) and high-risk (≥20%) categories of CVD show a significant difference between modified and traditional FRS: 67.4% versus 79.6% (low risk) and 13.7% versus 4.5% (high risk), respectively. The odds of having risk ≥10% was significantly greater in low-educated, abdominally obese individuals or those with lower consumption of breakfast cereal and fruit and vegetable and greater potato and potato products consumption. In conclusion, the traditional FRS method significantly underestimates CVD risk in Canadians; thus, applying modified FRS is beneficial for screening. Additionally, fibre consumption from fruit and vegetable or breakfast cereals might be beneficial in reducing CVD risks.
通过弗雷明汉风险评分（FRS）完成初步风险评估，以估计心血管疾病（CVD）的10年风险。2012年，加拿大心血管学会对FRS进行了两项修改：对于30至59岁、一级亲属在55岁之前（男性）或65岁之前（女性）患有CVD的受试者，FRS加倍；并为每个人计算心血管年龄。我们的目标是实施这些修改，并评估与传统FRS相比的差异。此外，我们评估了饮食摄入量与10年风险之间的关联。在30至74岁的参与者（n = 2730）中使用了加拿大健康措施调查数据周期1。使用STATA SE 11进行描述性和逻辑回归分析。与传统方法相比，使用改良FRS预测CVD的10年风险显著增加了估计风险，分别为8.66%±0.35%和6.06%±0.18%。在男性中，“心血管年龄”修改的影响比女性更大。加拿大人群中CVD低风险（<10%）和高风险（≥20%）类别之间的分布显示，改良FRS与传统FRS之间存在显著差异：分别为67.4%对79.6%（低风险）和13.7%对4.5%（高风险）。在低教育程度、腹部肥胖的个体中，或者在早餐谷物、水果和蔬菜摄入量较低且土豆及土豆制品摄入量较高的个体中，风险≥10%的几率显著更高。总之，传统FRS方法显著低估了加拿大人的CVD风险；因此，应用改良FRS有助于筛查。此外，从水果、蔬菜或早餐谷物中摄入纤维可能有助于降低CVD风险。
