Framingham Heart Model found to be a good predictor of high blood pressure in youth.
In 1948 little was known about the general causes of heart disease and stroke, but the death rates for CVD had been increasing steadily since the beginning of the century and had become an American epidemic. The Framingham Heart Study (FHS) ─ under the direction of the National Heart Institute (now the National Heart, Lung, and Blood Institute) ─ embarked on an ambitious project in health research. It set out to identify the common factors or characteristics that contribute to CVD by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke.
The research continues and, over the years, careful monitoring of the Framingham Study population has led to the identification of the major CVD risk factors ─ high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity ─ as well as a great deal of valuable information on the effects of related factors such as blood triglyceride and HDL cholesterol levels, age, gender, and psychosocial issues. The study has been applicable and valuable universally.
The FHS model has also been a predictor of short-term risk for hypertension. Now, researchers would add that it is a useful tool for identifying young adults at high risk for developing hypertension.
While most models are based on the presence of prehypertension, the FHS one includes age, gender, body mass index, smoking habits, parental history of hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), and the interaction between age and DBP.
Researchers from the University of Alabama at Birmingham applied the FHS formula to 4,388 adults aged 18 to 30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Lead author April Carson and colleagues found that “risk prediction models that go beyond the prehypertension classification” are better at identifying “young adults with an increased risk of hypertension, who may benefit from the adoption of preventive measures early in life.”
The FHS model was 84 percent accurate for discriminating between participants who did and did not develop hypertension, and was effective for both black and white participants, with respective accuracies of 81 percent and 87 percent. The most accurate individual components of the model were SBP, DBP, and the interaction between age and DBP, at 78 percent, 78 percent, and 81 percent, respectively. A model based solely on the presence of prehypertension was just 71percent accurate.
This is good news in light of findings from Wisconsin University’s School of Medicine and Public Health, that doctors who discover high blood pressure in young adults are less likely to officially diagnose them than they would 60 year-olds!