Recalibration of Framingham Risk for a local population of Sri Lanka 

Abstract Background Cardiovascular Diseases (CVD) account for highest number of deaths and disability globally and within Sri Lanka. A CVD risk prediction tool is a simple mean of early identification of high-risk groups which is a cost-effective preventive strategy especially for resource poor countries. Distribution of risk factor levels vary in different regions even within the same country, thus a common risk estimation tool for the country may give false local predictions. Since there’s few published data related to Sri Lanka the aim of this study was to recalibrate the Framingham equation according to the local risk factor profile of a population in Kurunegala region in Sri Lanka. Method A cross sectional study was conducted with the participation of 1 102 persons from Kurunegala Regional Director of Health Services area and the data was collectedusing an interviewer administered questionnaire, anthropometric, blood pressure and biochemical measurements. Results Original and recalibrated Framingham CVD risk scores predicted 55.5% (N = 612) and 62.3% (N=687) to be having less than 10% CVD risk respectively. Further, the original and recalibrated CVD Risk Scores predicted 2.2% (N = 24) and 1.8% (N=20) to be having CVD risk more than 40% respectively. Conclusion These findings show an over prediction of the CVD risk with the original Framingham risk calculations which signifies the importance of development of a region-specific risk prediction tool using local risk factor data in Sri Lanka whichwill prevent unnecessary expenditure to manage people without risk of CVD.