Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Amor, Antonio J.ca
• dc.contributor.author Serra-Mir, Mercèca
• dc.contributor.author Martínez-González, Miguel Ángel, 1957-ca
• dc.contributor.author Corella, Doloresca
• dc.contributor.author Salas-Salvadó, Jordica
• dc.contributor.author Fitó Colomer, Montserratca
• dc.contributor.author Estruch, Ramónca
• dc.contributor.author Serra-Majem, Luisca
• dc.contributor.author Arós, Fernandoca
• dc.contributor.author Babio, Nancyca
• dc.contributor.author Ros, Emilioca
• dc.contributor.author Ortega, Emilioca
• dc.contributor.author PREDIMED investigatorsca
• dc.date.accessioned 2017-06-20T12:05:25Z
• dc.date.available 2017-06-20T12:05:25Z
• dc.date.issued 2017
• dc.description.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.
• dc.format.mimetype application/pdfca
• dc.identifier.citation Amor AJ, Serra Mir M, Martínez-González MA, Corella D, Salas-Salvadó J, Fitó Colomer M et al. Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata. JAHA. 2017;6(3):e004803. DOI: 10.1161/JAHA.116.004803
• dc.identifier.doi http://dx.doi.org/10.1161/JAHA.116.004803
• dc.identifier.issn 2047-9980
• dc.identifier.uri http://hdl.handle.net/10230/32382
• dc.language.iso eng
• dc.publisher Wiley-Blackwellca
• dc.relation.ispartof JAHA. 2017;6(3):e004803
• dc.rights © 2017 Amor AJ, et al. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. http://dx.doi.org/10.1161/JAHA.116.004803.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri https://creativecommons.org/licenses/by-nc/4.0/
• dc.subject.keyword Cardiovascular disease
• dc.subject.keyword Cardiovascular risk prediction
• dc.subject.keyword Framingham-REGICOR equation
• dc.subject.keyword Mediterranean diet
• dc.subject.keyword PREDIMED
• dc.title Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strataca
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion