Framingham Ten-Year General XXXX Risk: Agreement between BMI-Based and Cholesterol-Based Estimates in a South Asian Convenience Sample.

@entity1 @entity65 @entity6
UNASSIGNED: The goal of this analysis was to determine the agreement between body mass index-based and cholesterol-based ten-year Framingham general @entity65 risk scores among a convenience sample of 773 South Asian Canadian adults attending community-based screening clinics. Scores were calculated using age, systolic blood pressure, antihypertensive use, current smoking, @entity6 , and total cholesterol and high density lipoprotein (for cholesterol-based risk) or height and weight (for body mass index-based risk). Mean risk score differences (body mass index-based risk minus cholesterol-based risk) were estimated using paired t-tests. Bland-Altman plots were used to assess agreement between scores. Finally, agreement across risk categories (low [<10%], moderate [10% to <20%], high [> = 20%]) was examined using the kappa statistic. Average agreement between the two risk scores was quite good overall (mean differences of 0.6% for @entity1 and 0.5% for @entity1 ), but increased to about 3% among @entity1 60-74 years of age. However, Bland-Altman plots revealed that the differences between the two scores and the variability of the differences increased with increasing average 10-year risk. In terms of clinical importance, the limits of agreement were reasonable for @entity1 < 60 years (95% confidence interval: -3.2% to 3.1%), but of concern for @entity1 60-74 years (95% confidence interval: -6.0% to 12.3%), @entity1 < 60 years (95% confidence interval: -7.1% to 7.3%) and @entity1 6-074 years (95% confidence interval: -13.8% to 18.8%). Agreement across categories was moderate for most sex and age groups examined (kappa values: 0.51 for @entity1 < 60 years, 0.50 for @entity1 60-74 years, 0.65 for @entity1 < 60 years), except for @entity1 60-74 years, where agreement was only fair (kappa = 0.26). In light of these disagreements, evaluation of a @entity1 's change in @entity65 risk over time will necessitate use of the same risk score (i.e., either body mass index-based or cholesterol-based) at all screening sessions.
