RT Journal Article
T1 Prediction of Cardiovascular Disease by the Framingham-REGICOR Equation in the High-Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata
A1 Amor, Antonio J.
A1 Serra-Mir, Merce
A1 Martinez-Gonzalez, Miguel A.
A1 Corella, Dolores
A1 Salas-Salvado, Jordi
A1 Fito, Montserrat
A1 Estruch, Ramon
A1 Serra-Majem, Lluis
A1 Aros, Fernando
A1 Babio, Nancy
A1 Ros, Emilio
A1 Ortega, Emilio
A1 PREDIMED Investigators, 
K1 cardiovascular disease
K1 cardiovascular risk prediction
K1 Framingham-REGICOR equation
K1 Mediterranean diet
K1 PREDIMED
K1 Association task-force
K1 Coronary-heart-disease
K1 American-college
K1 Primary prevention
K1 Relative validity
K1 Hdl-cholesterol
K1 Artery-disease
K1 Euroaspire iii
K1 Population
K1 Guideline
AB 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 PREvencion con DIeta MEDiterranea (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 nonhigh- 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.
PB Wiley
YR 2017
FD 2017-03-01
LK https://hdl.handle.net/10668/24804
UL https://hdl.handle.net/10668/24804
LA en
DS RISalud
RD Apr 10, 2025