Prediction of cardiovascular disease by the framingham-REGICOR equation in the high-risk PREDIMED cohort: Impact of the mediterranean diet across different risk strata

Autor: Antonio J. Amor, Mercè Serra‐Mir, Miguel A. Martínez‐González, Dolores Corella, Jordi Salas‐Salvadó, Montserrat Fitó, Ramón Estruch, Lluis Serra‐Majem, Fernando Arós, Nancy Babio, Emilio Ros, Emilio Ortega, A. Pérez‐Heras, C. Viñas, R. Casas, L. de Santamaría, S. Romero, E. Sacanella, G. Chiva, P. Valderas, S. Arranz, J. M. Baena, M. García, M. Oller, J. Amat, I. Duaso, Y. García, C. Iglesias, C. Simón, Ll. Quinzavos, Ll. Parra, M. Liroz, J. Benavent, J. Clos, I. Pla, M. Amorós, M. T. Bonet, M. T. Martin, M. S. Sánchez, J. Altirriba, E. Manzano, A. Altés, A. Sala‐Vila, M. Cofán, C. Valls‐Pedret, T. M. Freitas‐Simoes, M. Doménech, R. Gilabert, N. Bargalló, M. Bulló, J. Basora, R. González, A. Díaz‐López, C. Molina, G. Mena, F. Márquez, P. Martínez, N. Ibarrola, M. Sorli, J. García Roselló, F. Martín, N. Tort, A. Isach, A. Salas‐Huetos, N. Becerra‐Tomás, N. Rosique Esteban, J. J. Cabré, G. Mestres, F. Paris, M. Llaurado, R. Pedret, J. Basells, J. Vizcaino, R. Segarra, P. Hernandez‐Alonso, S. Giardina, C. Ferreira‐Pego, C. Papandreou, L. Camacho, E. Toledo, P. Buil‐Cosiales, M. Ruiz‐Canela, J. A. Martínez, B. Sanjulian, A. Sánchez‐Tainta, J. Diez‐Espino, C. Razquin, A. Garcia‐Arellano, E. Goni, Z. Vazquez, N. Berrade, V. Extremera‐Urabayen, S. Eguaras, A. Marti, C. Arroyo‐Azpa, L. García‐Pérez, J. Villanueva Telleria, F. Cortés Ugalde, T. Sagredo Arce, M. D. García de la Noceda Montoy, M. D. Vigata López, M. T. Arceiz Campo, A. Urtasun Samper, M. V. Gueto Rubio, A. Sola, N. Goñi, O. Lecea, S. Tello, J. Vila, R. de la Torre, D. Muñoz‐Aguayo, R. Elosua, J. Marrugat, H. Schröder, N. Molina, E. Maestre, O. Castañer, A. Rovira, M. Farre, J. V. Sorli, V. Zanon‐Moreno, P. Carrasco, C. Ortega‐Azorín, E. M. Asensio, R. Osma, R. Barragán, F. Francés, M. Guillén, J. I. González, C. Saiz, O. Portolés, F. J. Giménez, O. Coltell, P. Guillem‐Saiz, L. Quiles, V. Pascual, C. Riera, M. A. Pages, D. Godoy, A. Carratala‐Calvo, M. J. Martín‐Rillo, E. Llopis‐Osorio, J. Ruiz‐Baixauli, A. Bertolín‐Muñoz, I. Salaverría, T. del Hierro, J. Algorta, S. Francisco, A. Alonso‐Gómez, E. Sanz, J. Rekondo, M. C. Bello, A. Loma‐Osorio, E. Gómez‐Gracia, J. Warnberg, R. Benítez Pont, M. Bianchi Alba, R. Gómez‐Huelgas, J. Martínez‐González, V. Velasco García, J. de Diego Salas, A. Baca Osorio, J. Gil Zarzosa, J. J. Sánchez Luque, E. Vargas López, V. Ruiz‐Gutiérrez, J. Sánchez Perona, E. Montero Romero, M. García‐García, E. Jurado‐Ruiz, M. Fiol, M. García‐Valdueza, M. Moñino, A. Proenza, R. Prieto, G. Frontera, M. Ginard, F. Fiol, A. Jover, D. Romaguera, J. García, J. Lapetra, J. M. Santos‐Lozano, M. Ortega‐Calvo, L. Mellado, M. Leal, E. Martínez, F. José García, P. Román, P. Iglesias, Y. Corchado, L. Miró, C. Domínguez, J. M. Lozano, E. Mayoral, R. M. Lamuela‐Raventós, M. C. López‐Sabater, A. I. Castellote‐Bargallo, A. Tresserra‐Rimbau, J. Álvarez‐Pérez, E. M. Díaz‐Benítez, I. Bautista Castaño, A. Sánchez‐Villegas, M. J. Fernández‐Rodríguez, T. Casanas Quintana, J. Pérez‐Cabrera, M. Nissensohn, V. Díaz‐González, C. Ruano‐Rodríguez, A. P. Ortiz‐Andrelluchi, B. Macías Gutiérrez, A. J. Santana‐Santana, X. Pintó, E. de la Cruz, A. Galera, Y. Soler, F. Trias, I. Sarasa, E. Padres, E. Corbella, C. Cabezas, E. Vinyoles, M. A. Rovira, L. García, G. Flores, J. M. Verdú, P. Baby, A. Ramos, L. Mengual, P. Roura, M. C. Yuste, A. Guarner, M. I. Santamaría, M. Mata, C. de Juan, A. Brau, J. A. Tur, M. P. Portillo, G. Sáez, M. Aldamiz, A. Alonso, J. Berjón, L. Forga, J. Gallego, A. Larrauri, J. Portu, J. Timiraos, M. Serrano‐Martínez
Přispěvatelé: Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), Ministerio de Ciencia e Innovación (España), California Walnut Commission
Rok vydání: 2017
Předmět:
Male
Mediterranean diet
Epidemiology
Disease
030204 cardiovascular system & hematology
Diet
Mediterranean
Cohort Studies
0302 clinical medicine
Risk Factors
Medicine
030212 general & internal medicine
Risk assessment
Original Research
Diet and Nutrition
Aged
80 and over
Framingham Risk Score
Diabetis
Diabetes
Middle Aged
Prognosis
Cardiovascular disease
Primary Prevention
Cardiovascular diseases
Cardiovascular Diseases
Cohort
Female
Cardiology and Cardiovascular Medicine
Framingham‐REGICOR equation
PREDIMED
Cardiovascular risk prediction
Scale (ratio)
Risk Assessment
03 medical and health sciences
Humans
cardiovascular diseases
Aged
Proportional Hazards Models
Framingham-REGICOR equation
business.industry
Malalties cardiovasculars
Feeding Behavior
Lifestyle
Predimed
Diabetes Mellitus
Type 2
Spain
Avaluació del risc
Mediterraneam diet
business
Demography
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Recercat. Dipósit de la Recerca de Catalunya
instname
Dipòsit Digital de la UB
Universidad de Barcelona
Digital.CSIC. Repositorio Institucional del CSIC
Popis: 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.
This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission
Databáze: OpenAIRE
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