Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/177739
Title: Prediction of Cardiovascular Disease by the Framingham-REGICOR Equation in the High-Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata
Author: Amor, Antonio J.
Serra-Mir, Mercè
Martínez-González, Miguel Ángel, 1957-
Corella Piquer, Dolores
Salas Salvadó, Jordi
Fitó Colomer, Montserrat
Estruch Riba, Ramon
Serra Majem, Lluís
Arós, Fernando
Babio, Nancy
Ros Rahola, Emilio
Ortega, Emilio
PREDIMED Investigators
Keywords: Malalties cardiovasculars
Diabetis
Avaluació del risc
Cardiovascular diseases
Diabetes
Risk assessment
Issue Date: 13-Mar-2017
Publisher: American Heart Association
Abstract: Background: the usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham-REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high-risk in the PREvención con DIeta MEDiterránea (PREDIMED) study-a nutrition-intervention primary prevention trial-and the impact of adherence to the Mediterranean diet on CVD across risk categories. Methods and results: in a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55-74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate-adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham-REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6-year follow-up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata (P>0.4 for interaction). Conclusions: incident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non-high-risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD independent of baseline risk.
Note: Reproducció del document publicat a: https://doi.org/10.1161/JAHA.116.004803
It is part of: Journal of the American Heart Association, 2017, vol. 6, num. 3, p. e004803
URI: http://hdl.handle.net/2445/177739
Related resource: https://doi.org/10.1161/JAHA.116.004803
ISSN: 2047-9980
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (Nutrició, Ciències de l'Alimentació i Gastronomia)
Articles publicats en revistes (Ciències Clíniques)

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