Risk functions for prediction of cardiovascular disease in elderly Australians: the Dubbo Study.

OBJECTIVES To evaluate a Framingham risk function for coronary heart disease in an elderly Australian cohort and to derive a risk function for cardiovascular disease (CVD) in elderly Australians. DESIGN AND SETTING Analysis of data from a prospective cohort study (the Dubbo Study) in a semi-urban town (population, 34 000). PARTICIPANTS 2805 men and women 60 years and older living in the community, first assessed in 1988, and a subcohort of 2102 free of CVD at study entry. MAIN OUTCOME MEASURES Incidence of CVD (myocardial infarction, coronary death or stroke) over 5 and 10 years. RESULTS A Framingham risk function assessing "hard" coronary heart disease (ie, myocardial infarction or coronary death) accurately predicted 10-year incidence in men and women aged 60-79 years who were free of prevalent CVD or diabetes at study entry. In a multiple logistic model, CVD incidence was significantly predicted by age, sex, taking antihypertensive medication, blood pressure, smoking, total cholesterol level and diabetes. For a given age and cholesterol level, CVD risk over 5 years was doubled in the presence of antihypertensive medication or diabetes, increased by 50% with cigarette smoking, and halved in women compared with men. CONCLUSIONS We have derived a simple CVD risk function specifically for elderly Australians that employs risk factors readily accessible to all medical practitioners.