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Richard Milne

Publications and source records attributed to Richard Milne.

5 recordsLinked to original sources
PubMed2003

Framingham Heart Study risk equation predicts first cardiovascular event rates in New Zealanders at the population level.

AIM: To establish the population-level predictive validity of the Framingham Heart Study risk equation used to derive cardiovascular disease risk-prediction charts for New Zealand management guidelines on raised blood pressure and dyslipidaemia. METHODS: During 1992-3, standard cardiovascular risk factors were measured in a cohort of 6354 people (4638 men and 1716 women) aged 35-74 years with no history of cardiovascular disease, who were either enrolled on Auckland general electoral rolls or employed by a nationwide multi-industry corporation. Five-year cardiovascular event rates were predicted for the cohort using a Framingham risk equation and were compared with observed five-year cardiovascular event rates for hospitalisation and mortality. RESULTS: Incident cardiovascular hospitalisations or death were reported for 411 cohort participants (325 men and 86 women) during five years of follow up. There was good agreement between observed and predicted five-year cardiovascular event rates in all five-year age/sex categories up to 69 years. The risk equation tended to underestimate risk slightly in men and overestimate risk slightly in women up to 69 years, while in 70- to 74-year-olds it was accurate for men. Its accuracy in older women is uncertain. CONCLUSION: A Framingham Heart Study risk equation used to estimate incident cardiovascular events in individuals without previous cardiovascular disease accurately predicts five-year risk of hospitalisation or death from a first cardiovascular event in New Zealand men aged 35-74 and women aged 35-69 years at the population level.

Adult↗
PubMed2003

Discriminative ability of a risk-prediction tool derived from the Framingham Heart Study compared with single risk factors.

AIM: To compare the discriminative ability of a multivariate risk-prediction model with individual continuous cardiovascular risk factors in a free-living population. METHODS: Standard cardiovascular risk factors were measured in 6354 participants (4638 men and 1716 women) aged 35 to 74 years with no history of cardiovascular disease either enrolled on Auckland general electoral rolls or employed by a New Zealand-wide multi-industry corporation, in 1992-3. The sensitivity and specificity of individual risk factors versus a five-year cardiovascular risk-prediction equation and the corresponding New Zealand risk charts in predicting hospitalisation and mortality from cardiovascular disease in the subsequent five-year period were estimated over a range of risk thresholds. RESULTS: Discrimination between individuals who had or did not have subsequent cardiovascular events was poor for individual risk factors. Increasing age had significantly more discriminability than blood pressure or lipids and the Framingham Heart Study risk tool had better discriminability than any single risk factor. CONCLUSIONS: A Framingham risk equation and corresponding New Zealand risk charts discriminate between individuals who will or will not experience hospitalisation or death from cardiovascular events. Discriminability is only modest but it is better than that achieved using individual risk factors.

Adult↗