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Author Notes:

Corresponding Author: Arshed A. Quyyumi MD, Professor of Medicine, Division of Cardiology, Co-Director, Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road N.E. Suite 510, Atlanta, GA 30322, Tel: (404) 727-3655, Fax: (404) 712-8785, aquyyum@emory.edu.

We wish to thank all the participants of the META-Health and Predictive Health studies who contributed their time and effort for this project.

Disclosures: None


Research Funding:

NIH/NHLBI 1 U01 HL079156-01 (Quyyumi) and 1 U01 HL79214-01 (Gibbons).

Further support was provided by the Emory Heart and Vascular Center and grants from the National Institutes of Health (UL1 RR025008 from the Clinical and Translational Science Award program, R01 HL089650 and R01 HL113451) as well as the American Heart Association (AHA) Strategically Focused Research Network on Disparities (Grant 0000031288).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology

Comparisons of the Framingham and Pooled Cohort Equation Risk Scores for Detecting Subclinical Vascular Disease in Blacks Versus Whites

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Journal Title:

American Journal of Cardiology


Volume 121, Number 5


, Pages 564-569

Type of Work:

Article | Post-print: After Peer Review


The pooled cohort Atherosclerotic Cardiovascular Disease (ASCVD) risk calculator is designed to improve cardiovascular risk estimation compared with the Framingham Risk Score, particularly in blacks. Although the ASCVD risk score better predicts mortality and incident cardiovascular disease in blacks, less is known about its performance for subclinical vascular disease measures, including arterial stiffness and carotid intima-media thickness. We sought to determine if the ASCVD risk score better identifies subclinical vascular disease in blacks compared with the Framingham risk score. We calculated both the Framingham and ASCVD cohort risk scores in 1,231 subjects (mean age 53 years, 59% female, 37% black) without known cardiovascular disease and measured the extent of arterial stiffness, as determined by pulse wave velocity (PWV), central pulse pressure (CPP), and central augmentation index (CAIx), and subclinical atherosclerosis, as determined by carotid-IMT (C-IMT). Compared with whites, blacks had higher CAIx (23.9 ± 10.2 vs 22.1 ± 9.6%, p = 0.004), CPP (36.4 ± 10.5 vs 34.9 ± 9.8 mmHg, p = 0.014), PWV (7.6 ± 1.5 vs 7.3 ± 1.3 m/s, p = 0.004), and C-IMT (0.67 ± 0.10 vs 0.65 ± 0.10 mm, p = 0.005). In a multivariable analysis including race and Framingham risk score, race remained an independent predictor of all measures of subclinical vascular disease; however, models with race and the ASCVD risk score showed that race was not an independent predictor of subclinical vascular disease. In conclusion, greater subclinical vascular disease in blacks was not estimated by the Framingham risk score. The new ASCVD risk score provided a better estimate of racial differences in vascular function and structure.

Copyright information:

© 2017 Elsevier Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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