Framingham Risk Factors' Value Seems to Decrease With Age

Conventional risk factors appear to have lower predictive ability for CVD in older adults

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22 aug 2009-- The predictive value of conventional risk factors for cardiovascular disease (CVD) appears to decrease in older adults, with C-reactive protein (CRP) providing little additional value, according to research published in the Aug. 15 issue of the American Journal of Cardiology.

Mark Hamer, Ph.D., of the University College London, and colleagues analyzed data from 5,944 individuals without existing CVD. Participants were followed for an average of 7.1 years, and were classified as young (ages 35 to 50 years), middle-aged (51 to 65 years), and older (65 years and older).

The researchers found that, in predicting CVD events, the area under the curve for the Framingham risk factor model was higher in the younger and middle-aged groups (receiver operating characteristic curves, 0.78 and 0.72, respectively) than the older group (0.59). Adding the CRP data didn't substantially increase the discriminative ability.

"Our main findings showed that conventional risk factors using the Framingham model appear to have lower discriminative power in older adults, although the prediction of CVD events was not substantially improved by adding CRP, despite an independent association between CRP and the risk of clinical events in Cox proportional hazards models," the authors write. "Our findings are largely consistent with the results of recent studies of elderly cohorts, in which the prediction of CVD events was not substantially improved by the addition of CRP to conventional risk factors."

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