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

© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell..

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.

CLINICAL TRIAL REGISTRATION: URL: http://www.Controlled-trials.com. Unique identifier: ISRCTN35739639.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:6

Enthalten in:

Journal of the American Heart Association - 6(2017), 3 vom: 13. März

Sprache:

Englisch

Beteiligte Personen:

Amor, Antonio J [VerfasserIn]
Serra-Mir, Mercè [VerfasserIn]
Martínez-González, Miguel A [VerfasserIn]
Corella, Dolores [VerfasserIn]
Salas-Salvadó, Jordi [VerfasserIn]
Fitó, Montserrat [VerfasserIn]
Estruch, Ramón [VerfasserIn]
Serra-Majem, Lluis [VerfasserIn]
Arós, Fernando [VerfasserIn]
Babio, Nancy [VerfasserIn]
Ros, Emilio [VerfasserIn]
Ortega, Emilio [VerfasserIn]
PREDIMED Investigators [VerfasserIn]
Pérez-Heras, A [Sonstige Person]
Viñas, C [Sonstige Person]
Casas, R [Sonstige Person]
de Santamaría, L [Sonstige Person]
Romero, S [Sonstige Person]
Sacanella, E [Sonstige Person]
Chiva, G [Sonstige Person]
Valderas, P [Sonstige Person]
Arranz, S [Sonstige Person]
Baena, J M [Sonstige Person]
García, M [Sonstige Person]
Oller, M [Sonstige Person]
Amat, J [Sonstige Person]
Duaso, I [Sonstige Person]
García, Y [Sonstige Person]
Iglesias, C [Sonstige Person]
Simón, C [Sonstige Person]
Quinzavos, Ll [Sonstige Person]
Parra, Ll [Sonstige Person]
Liroz, M [Sonstige Person]
Benavent, J [Sonstige Person]
Clos, J [Sonstige Person]
Pla, I [Sonstige Person]
Amorós, M [Sonstige Person]
Bonet, M T [Sonstige Person]
Martin, M T [Sonstige Person]
Sánchez, M S [Sonstige Person]
Altirriba, J [Sonstige Person]
Manzano, E [Sonstige Person]
Altés, A [Sonstige Person]
Sala-Vila, A [Sonstige Person]
Cofán, M [Sonstige Person]
Valls-Pedret, C [Sonstige Person]
Freitas-Simoes, T M [Sonstige Person]
Doménech, M [Sonstige Person]
Gilabert, R [Sonstige Person]
Bargalló, N [Sonstige Person]
Bulló, M [Sonstige Person]
Basora, J [Sonstige Person]
González, R [Sonstige Person]
Díaz-López, A [Sonstige Person]
Molina, C [Sonstige Person]
Mena, G [Sonstige Person]
Márquez, F [Sonstige Person]
Martínez, P [Sonstige Person]
Ibarrola, N [Sonstige Person]
Sorli, M [Sonstige Person]
García Roselló, J [Sonstige Person]
Martín, F [Sonstige Person]
Tort, N [Sonstige Person]
Isach, A [Sonstige Person]
Salas-Huetos, A [Sonstige Person]
Becerra-Tomás, N [Sonstige Person]
Rosique Esteban, N [Sonstige Person]
Cabré, J J [Sonstige Person]
Mestres, G [Sonstige Person]
Paris, F [Sonstige Person]
Llaurado, M [Sonstige Person]
Pedret, R [Sonstige Person]
Basells, J [Sonstige Person]
Vizcaino, J [Sonstige Person]
Segarra, R [Sonstige Person]
Hernandez-Alonso, P [Sonstige Person]
Giardina, S [Sonstige Person]
Ferreira-Pego, C [Sonstige Person]
Papandreou, C [Sonstige Person]
Camacho, L [Sonstige Person]
Toledo, E [Sonstige Person]
Buil-Cosiales, P [Sonstige Person]
Ruiz-Canela, M [Sonstige Person]
Martínez, J A [Sonstige Person]
Sanjulian, B [Sonstige Person]
Sánchez-Tainta, A [Sonstige Person]
Diez-Espino, J [Sonstige Person]
Razquin, C [Sonstige Person]
Garcia-Arellano, A [Sonstige Person]
Goni, E [Sonstige Person]
Vazquez, Z [Sonstige Person]
Berrade, N [Sonstige Person]
Extremera-Urabayen, V [Sonstige Person]
Eguaras, S [Sonstige Person]
Marti, A [Sonstige Person]
Arroyo-Azpa, C [Sonstige Person]
García-Pérez, L [Sonstige Person]
Villanueva Telleria, J [Sonstige Person]
Cortés Ugalde, F [Sonstige Person]
Sagredo Arce, T [Sonstige Person]
de la Noceda Montoy, M D García [Sonstige Person]
Vigata López, M D [Sonstige Person]
Arceiz Campo, M T [Sonstige Person]
Urtasun Samper, A [Sonstige Person]
Gueto Rubio, M V [Sonstige Person]
Sola, A [Sonstige Person]
Goñi, N [Sonstige Person]
Lecea, O [Sonstige Person]
Tello, S [Sonstige Person]
Vila, J [Sonstige Person]
de la Torre, R [Sonstige Person]
Muñoz-Aguayo, D [Sonstige Person]
Elosua, R [Sonstige Person]

Links:

Volltext

Themen:

Cardiovascular disease
Cardiovascular risk prediction
Framingham‐REGICOR equation
Journal Article
Mediterranean diet
Multicenter Study
PREDIMED
Randomized Controlled Trial

Anmerkungen:

Date Completed 06.03.2018

Date Revised 12.11.2023

published: Electronic

Citation Status MEDLINE

doi:

10.1161/JAHA.116.004803

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM269796312