Procam y Framingham por categorías: ¿Miden igual riesgo?

Abstract

Objective: To compare two methods to calculate cardiovascular risk, PROCAM and Framingham using risk factors categories (hard events), in men between 45 and 65 years. Material and methods: We present a descriptive crossover study, made between January and December of 1999. The study was made in Primary Heatlh Care. We have examined all of men between 45 and 65 years, which belong to four family doctors in three health centers, without cardiovascular disease (n=402). For every man, it was analysed: age, diabetes mellitus, smoke, family history of premature coronary heart disease, systolic blood pressure, diastolic blood pressure, total cholesterol, LDL-cholesterol, HDL-cholesterol, tryglicerides. To compare both methods we used Pearson correlation coefficient, intraclass correlation coefficient (ICC), and the graphic representation was made with the Bland and Altman model. Results: Average cardiovascular risk was 8.56 ± 9.3% with PROCAM method versus 10.85 ± 6.8% with Framingham using risk factors categories. Pearson correlation coefficient was 0.859 (p< 0.001), ICC was 0.778 (p< 0.001). Average difference between PROCAM and Framingham using risk factors categories was -2.2% ± 4.9 p< 0.001. Conclusions: Even the correlation coefficients are higher than 0.75, and the average difference are 2.2%, there are a great variability in the individuals differences with the increase risk. Compared with Framingham using risk factors categories, for a low risk, PROCAM underestimates this risk, while, for a high risk PROCAM overvalues the risk.