Multivariate risk estimation for coronary heart disease: the Busselton Health Study

Coronary heart disease (CHD) is a multifactorial disease and CHD risk shoul d be estimated by assessing all cardiovascular risk factors simultaneously. Simply adding up the number of factors with 'at risk' values fails to iden tify high-risk subjects with multiple risk factors at moderately elevated v alues. A more efficient approach is to use a quantitative multivariate risk score. A number of overseas studies have produced CHD risk scoring systems for men. There are few risk scores developed for women and no CHD risk sco res have been developed from Australian data. This study used data on CHD r isk factors and morbidity/mortality follow-up for the 1978 Busselton Health Survey participants to provide age-specific estimates of absolute risk of CHD hospitalisation or death, and to develop multivariate CHD risk scoring systems for men and women. The scores are based on age, blood pressure, ant i-hypertensive medication, total and HDL cholesterol, smoking, diabetes, le ft ventricular hypertrophy and previous history of CHD. The generalisabilit y and applicability of these risk estimation systems to Australian populati ons in the late 1990s is discussed.