Koohi Fatemeh, Steyerberg Ewout W, Cheraghi Leila, Abdshah Alireza, Azizi Fereidoun, Khalili Davood
Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2021 Apr 24;21(1):790. doi: 10.1186/s12889-021-10760-6.
The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population.
We studied 5423 participants, aged 20-69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell's concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models.
Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79-0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision.
The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.
弗雷明汉高血压风险评分是一种用于预测成年人高血压的知名且简单的模型。在本研究中，我们旨在评估该模型在中东人群中的预测能力。
我们研究了5423名年龄在20 - 69岁之间、无高血压的参与者，他们参加了德黑兰血脂与血糖研究（TLGS）的两个连续检查周期。我们基于哈雷尔一致性统计量（c指数）评估辨别力，并进行校准（预测值与观察值的图形比较）。我们评估了原始模型、重新校准后的模型（针对截距和斜率）以及修订后的模型（针对β系数）。
在3年的随访期内，319名参与者患上了高血压。弗雷明汉高血压风险评分在区分患高血压者和未患高血压者方面表现良好（c指数 = 0.81，95%置信区间：0.79 - 0.83）。最初，原始风险评分（预测事件）存在系统性低估，通过简单的模型修订很容易得到纠正。
修订后的弗雷明汉高血压风险评分可作为公共卫生和临床实践中的筛查工具，以促进对中东高危人群进行预防性干预。
