ArticleCirculation2012
Comparison of the Framingham and Reynolds Risk scores for global cardiovascular risk prediction in the multiethnic Women's Health Initiative.
Article in Circulation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 106 papers, 3 of them syntheses that pooled it.
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Who cites it
106 citing papers in PubMed, 3 syntheses or guidelines pooled it.
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- Risk prediction models for contrast induced nephropathy: systematic review.BMJ (Clinical research ed.) · 2015Pooled it
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- Quantifying cardiometabolic risk using modifiable non-self-reported risk factors.American journal of preventive medicine · 2014Trial
- Bridging the Practice Gap: Polycystic Ovary Syndrome as an Under-Recognised Risk State for Ischaemic Stroke and Cardiovascular Disease.Journal of clinical medicine · 2026Review
- Cardiovascular risk and obesity in miner workers exposed to intermittent hypobaric hypoxia in the Peruvian Andes.Frontiers in physiology · 2026Article
- Racial differences in breast cancer-specific mortality and CVD-specific mortality after breast cancer in post-menopausal women.Cardio-oncology (London, England) · 2025Article
- Comparison of Cardiovascular Risk Estimation and Statin Prescribing in Primary Care: A Retrospective Cohort Study.Cureus · 2025Article
- Hypertensive disorders of pregnancy and gestational diabetes mellitus and predicted risk of maternal cardiovascular disease 10-14 years after delivery: A prospective cohort.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Assessing the association between dairy consumption and the 10-year Framingham Risk Score in women.BMC nutrition · 2025Article
- Cardiovascular disease risk prediction by Framingham risk score in women with polycystic ovary syndrome.Reproductive biology and endocrinology : RB&E · 2025Article
- Cardiovascular Risk Estimation in Colombia Using Artificial Intelligence Techniques.Cardiology research and practice · 2025Article
- Explainable machine learning model of coronary artery disease combined with diabetes: development and validation study.Frontiers in cardiovascular medicine · 2025Article
- Sex in cardiovascular disease: Why this biological variable should be considered in in vitro models.Science advances · 2024Review
- Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts.Women's health reports (New Rochelle, N.Y.) · 2024Article
- Women, lipids, and atherosclerotic cardiovascular disease: a call to action from the European Atherosclerosis Society.European heart journal · 2023Article
- Cardiometabolic Risk: Characteristics of the Intestinal Microbiome and the Role of Polyphenols.International journal of molecular sciences · 2023Review
46 more citing papers are in PubMed but not listed here.
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Abstract
backgroundFramingham-based and Reynolds Risk scores for cardiovascular disease (CVD) prediction have not been directly compared in an independent validation cohort. METHODS AND
resultsWe selected a case-cohort sample of the multiethnic Women's Health Initiative Observational Cohort, comprising 1722 cases of major CVD (752 myocardial infarctions, 754 ischemic strokes, and 216 other CVD deaths) and a random subcohort of 1994 women without prior CVD. We estimated risk using the Adult Treatment Panel III (ATP-III) score, the Reynolds Risk Score, and the Framingham CVD model, reweighting to reflect cohort frequencies. Predicted 10-year risk varied widely between models, with ≥10% risk in 6%, 10%, and 41% of women with the ATP-III, Reynolds, and Framingham CVD models, respectively. Calibration was adequate for the Reynolds model, but the ATP-III and Framingham CVD models overestimated risk for coronary heart disease and major CVD, respectively. After recalibration, the Reynolds model demonstrated improved discrimination over the ATP-III model through a higher c statistic (0.765 versus 0.757; P=0.03), positive net reclassification improvement (NRI; 4.9%; P=0.02), and positive integrated discrimination improvement (4.1%; P<0.0001) overall, excluding diabetics (NRI=4.2%; P=0.01), and in white (NRI=4.3%; P=0.04) and black (NRI=11.4%; P=0.13) women. The Reynolds (NRI=12.9%; P<0.0001) and ATP-III (NRI=5.9%; P=0.0001) models demonstrated better discrimination than the Framingham CVD model.
conclusionsThe Reynolds Risk Score was better calibrated than the Framingham-based models in this large external validation cohort. The Reynolds score also showed improved discrimination overall and in black and white women. Large differences in risk estimates exist between models, with clinical implications for statin therapy.
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