A new method for CHD prediction and prevention based on regional risk scores and randomized clinical trials;: PRECARD® and the Copenhagen Risk Score

被引:102
作者
Thomsen, TF
Davidsen, M
Ibsen, H
Jorgensen, T
Jensen, G
Borch-Johnsen, K
机构
[1] Univ Copenhagen, Glostrup Hosp, Med Dept M, Ctr Prevent Med, DK-2600 Glostrup, Denmark
[2] HS Bispebjerg Univ Hosp, Copenhagen City Heart Study, Copenhagen, Denmark
[3] Steno Diabet Ctr, Gentofte, Denmark
来源
JOURNAL OF CARDIOVASCULAR RISK | 2001年 / 8卷 / 05期
关键词
prediction; prevention; risk score; coronary heart disease; randomised clinical trials; computer program; tailored health advice; guidelines; myocardial infarction; Cox regression;
D O I
10.1097/00043798-200110000-00008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background There is a considerable gap between the recommended prevention of coronary heart disease (CHD) in the guidelines from the European Society of Cardiology and the actually conducted clinical practice in preventive cardiology. A new method for implementing the recommended clinical practice in preventive cardiology is described. Aim To develop a comprehensive and flexible health educational computer program (the PRECARD (R) program) for individual coronary risk prediction and multifactorial prevention. Material and methods The PRECARD (R) program contains a new coronary risk score (the Copenhagen Risk Score) for myocardial infarction and a model for calculating the effect of intervention. Two Danish population studies (n = 11 765) with 10 years of follow up were used to establish the risk score. The included risk factors were: age, sex, cholesterol (incl. HDL), systolic blood pressure, smoking, body mass index, diabetes, familial predisposition and previous heart disease. Nine randomized clinical trials were used to estimate the effect of intervention. Results The findings in the Copenhagen Risk Score and the estimated effect of intervention deducted from the clinical trials were comparable to other similar studies. The PRECARD (R) program gives a graphical or numerical presentation of absolute coronary risk, the potential benefit of intervention, the relative impact of modifiable risk factors and numbers needed to treat. The program compiles individually tailored health messages in print for the patient. The program can easily be adjusted to different regional risk scores, other end-points and languages. Conclusion The PRECARD (R) program may promote the recommended clinical practice in preventive cardiology by serving as an integrated part of the lifestyle consultation.
引用
收藏
页码:291 / 297
页数:7
相关论文
共 33 条
  • [1] Andersen P. K., 2012, Statistical models based on counting processes
  • [2] AN UPDATED CORONARY RISK PROFILE - A STATEMENT FOR HEALTH-PROFESSIONALS
    ANDERSON, KM
    WILSON, PWF
    ODELL, PM
    KANNEL, WB
    [J]. CIRCULATION, 1991, 83 (01) : 356 - 362
  • [3] [Anonymous], 1991, JAMA, V265, P3255
  • [4] Psycho-social determinants and motivational phases in smoking behavior of cardiac inpatients
    Bolman, C
    de Vries, H
    [J]. PREVENTIVE MEDICINE, 1998, 27 (05) : 738 - 747
  • [5] BLOOD-PRESSURE, STROKE, AND CORONARY HEART-DISEASE .2. SHORT-TERM REDUCTIONS IN BLOOD-PRESSURE - OVERVIEW OF RANDOMIZED DRUG TRIALS IN THEIR EPIDEMIOLOGIC CONTEXT
    COLLINS, R
    PETO, R
    MACMAHON, S
    HEBERT, P
    FIEBACH, NH
    EBERLEIN, KA
    GODWIN, J
    QIZILBASH, N
    TAYLOR, JO
    HENNEKENS, CH
    [J]. LANCET, 1990, 335 (8693) : 827 - 838
  • [6] THE NUMBER NEEDED TO TREAT - A CLINICALLY USEFUL MEASURE OF TREATMENT EFFECT
    COOK, RJ
    SACKETT, DL
    [J]. BRITISH MEDICAL JOURNAL, 1995, 310 (6977) : 452 - 454
  • [7] COX DR, 1972, J R STAT SOC B, V34, P187
  • [8] MORBIDITY AND MORTALITY IN THE SWEDISH TRIAL IN OLD PATIENTS WITH HYPERTENSION (STOP-HYPERTENSION)
    DAHLOF, B
    LINDHOLM, LH
    HANSSON, L
    SCHERSTEN, B
    EKBOM, T
    WESTER, PO
    [J]. LANCET, 1991, 338 (8778) : 1281 - 1285
  • [9] General practice registrar responses to the use of different risk communication tools in simulated consultations: a focus group study
    Edwards, A
    Elwyn, G
    Gwyn, R
    [J]. BRITISH MEDICAL JOURNAL, 1999, 319 (7212) : 749 - 752
  • [10] GREENBERG G, 1985, BMJ-BRIT MED J, V291, P97