Quantifying the Risk of Coronary Artery Disease in a Community. The Bambuí Project

Abstract

Objective - To determine the coronary risk profile in adults and elderly in a community. Methods - The study comprised a sample of adults (30-59 years, n=547) and the entire elderly population (60- 74 years, n=1165) residing in Bambuí town, Brazil. The Framingham score based on sex, age, smoking, diabetes mellitus, systolic and diastolic blood pressure, total cholesterol, and HDL-C was used. The score based on age and sex was defined as "expected" and compared with the mean score obtained by the sum of all risk factors in each age group and sex (score "observed"). Results - The difference between the scores "observed" and "expected" increased with aging in both sexes. Smoking increased the difference from 30 years of age onwards, in both sexes, and hypertension was important in men above the age of 30 years and in women above the age of 50 years. Diabetes and elevated total cholesterol increased the risk of the disease above the age of 50 years in both sexes. A higher level of HDL-C reduced the risk among men above the age of 30 years, with no significant difference among women. Less schooling (< 4 years versus ≥ 4 years) was associated with a higher score in adults of both sexes, but not among the elderly. Conclusion - Based on these results, in the community studied, the risk of coronary artery disease may be reduced up to 44% in men and 38% in women.