Assessing 10-year coronary heart disease risk in people with Type 2 diabetes mellitus: Framingham versus United Kingdom Prospective Diabetes Study

Abstract

Aims: Previous studies have suggested that the Framingham coronary heart disease risk prediction equation underestimates risk among people with Type 2 diabetes. We compared the 10-year absolute risks of coronary heart disease (CHD) using a Framingham equation and a United Kingdom Prospective Diabetes Study (UKPDS) equation in adults with Type 2 diabetes. Methods: Participants were from a cross-sectional survey of a randomly selected population. There were 461 people with newly (n = 132) or previously diagnosed (n = 329) diabetes aged 35 to 74 years with no past history of cardiovascular disease or nephropathy. We examined predicted 10-year CHD risk by age, gender, and newly or previously diagnosed diabetes. Results: Overall the mean 10-year CHD risks predicted by the two equations were similar. Among men, the UKPDS and Framingham scores were almost identical below 60 years of age but at older ages, the UKPDS score was 4%-11% higher than Framingham. For women, the Framingham score was higher than the UKPDS score between ages 40 and 65 years, but the UKPDS score was about 4%-5% higher for women aged 70 years and over. The UKPDS equation tended to give higher risk estimates in people with a predicted 10-year Framingham CHD risk above 15%. Conclusion: Framingham CHD risk scores tended to be lower than UKPDS scores primarily in people above standard thresholds for drug treatment, so the clinical impact of underestimating risk is likely to be limited. Moreover, the UKPDS equation predicted lower risks than Framingham for women and newly diagnosed diabetes at otherwise low to moderate CHD risk, which could result in later initiation of therapy in these groups if the UKPDS score was used instead of the Framingham score.

The Ten-Year Risk Prediction for Cardiovascular Disease for Malaysian Adults Using the Laboratory-Based and Office-Based (Globorisk) Prediction Model

“…Men have higher CVD risk scores than women in Malaysia. This result is in line with previous studies [ 3 , 6 , 35 ]. For the 10-year risk of fatal CVD, our findings for men and women with a high-risk CVD risk score (See Table 2 ) were lower than those of South Korea (men: 7.0%, women: 7.0%) and China (men: 33.0%, women: 28.0%) [ 16 ].…”

10-Year Cardiovascular Disease Risk Estimation Based on Lipid Profile-Based and BMI-Based Framingham Risk Scores across Multiple Sociodemographic Characteristics: The Malaysian Cohort Project

“…This was not surprising as the CVD risk factors among males were consistently worse than females, especially, based on the higher prevalence of smoking status, higher systolic blood pressure, lower HDL level, and higher diabetes comorbidity status. A recent study in 2014 conducted among European diabetics [ 21 ] also demonstrated similar findings, with females having a lower 10-year CVD risk compared to males (13.4% and 18.5%, respectively). Conversely, a study among the Jamaican population showed no significant difference of the 10-year CVD risk between the genders [ 22 ].…”

The Ten-year Risk Prediction for Cardiovascular Disease in the National Population (Globorisk) of Malaysian Adults

“…Men have higher CVD risk scores than women in Malaysia. This result is in line with previous studies that have found similar results 4,7,24 . For the 10-year risk of fatal CVD, our ndings for men and women with a high-risk CVD risk score (See Table 2) were lower than those of South Korea (men: 7.0%, women: 7.0%)…”