1. Estimation of Lifetime Risk of Cardiovascular Disease (IBERLIFERISK): A New Tool for Cardiovascular Disease Prevention in Primary Care.
- Author
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Brotons C, Moral I, Fernández D, Puig M, Calvo Bonacho E, Martínez Muñoz P, Catalina Romero C, and Quevedo Aguado LJ
- Subjects
- Adolescent, Adult, Aged, Cardiovascular Diseases epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Morbidity trends, Prognosis, Retrospective Studies, Sex Factors, Spain epidemiology, Survival Rate trends, Young Adult, Cardiovascular Diseases prevention & control, Forecasting, Primary Health Care methods, Primary Prevention methods, Risk Assessment methods
- Abstract
Introduction and Objectives: To develop a predictive function of lifetime cardiovascular risk, including morbidity and mortality, in a healthy working population in Spain., Methods: Retrospective cohort study. We selected healthy workers, aged 18 to 65 years, with no history of cardiovascular disease, who underwent a health assessment between 2004 and 2007. We used 70% of the cohort to develop the risk equation, and the remaining 30% to validate the equation. Four Cox proportional hazards models were constructed using cardiovascular events and competing events as dependent variables. The same models were replicated for men and women separately. Fatal and nonfatal events were assessed until 2014., Results: A total of 762 054 individuals were selected. The mean age was 35.48 years and 71.14% were men. Significant risk variables in the model included manual occupations, being a smoker or exsmoker, diabetes mellitus, antihypertensive treatment, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and lipid-lowering treatment; in men, the model also included alcohol consumption, body mass index, a family history of early coronary disease in first-degree relatives, renal failure, and diastolic blood pressure. The area under the curve receiver operating characteristic was 0.84 (95%CI, 0.82-0.85) in men and 0.73 (95%CI, 0.66-0.80) in women. Calibration showed underestimation in low-risk deciles and overestimation in high-risk deciles., Conclusions: The new lifetime cardiovascular risk model has satisfactory discrimination and calibration, with better results in men than in women., (Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
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