PREDICTION OF CORONARY HEART-DISEASE MORTALITY IN BUSSELTON, WESTERN-AUSTRALIA - AN EVALUATION OF THE FRAMINGHAM, NATIONAL-HEALTH EPIDEMIOLOGIC FOLLOW-UP-STUDY, AND WHO ERICA RISK SCORES

Study objectives-To evaluate the performance of the Framingham, nation al health epidemiologic follow up study, and the WHO ERICA risk scores in predicting death from coronary heart disease (CHD) in an Australia n population. Design-Cohort follow up study. Setting and participants- The cohort consisted of 1923 men and 1968 women who participated in he alth surveys in the town of Busselton in Western Australia over the pe riod 1966-81. Baseline assessment included cardiovascular risk factor measurement. Mortality follow up to 31 December 1994 was used. Main re sults-Risk scores for death from CHD within 10 years based on age, sys tolic blood pressure, cholesterol, smoking, and BMI were derived from the Busselton study data using logistic regression analysis. Similar r isk scores developed from the Framingham, the national health epidemio logic follow up study, and the WHO ERICA cohorts were found to perform just as well in Busselton as the Busselton-derived scores, both befor e and after controlling the effect of age. There was considerable over lap across the different risk scores in the identification of individu als in the highest quintile of risk. Those in the top 20% of scores in cluded about 41% of deaths from CHD among men and about 63% of deaths from CHD among women. Conclusion-Although there is variation in risk s core coefficients across the studies, the relative risk predictive per formance of the scores is similar. The use of Framingham and other sim ilar risk scores will not be misleading in white Australian population s.