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Adaptation of the Framingham-Wilson Coronary Risk Equation for the Population of Navarra (RICORNA).

INTRODUCTION AND OBJECTIVES: The Framingham equations overestimate the risk of coronary disease in populations with a low disease incidence. It is more appropriate to take the local population's characteristics into account when estimating coronary risk. Accordingly, the Framingham-Wilson equation has been adapted for the population of Navarra, Spain. This article presents 10- year overall coronary risk charts.

METHODS: The Framingham-Wilson equation was adapted using data on the prevalence of cardiovascular risk factors and the coronary event rate in the population of Navarra. The version of the Framingham-Wilson equation used included high-density lipoprotein cholesterol (HDL-C). The probability of an event at 10 years for different combinations of risk factors, with an HDL-C concentration of 35-59 mg/dL, are illustrated.

RESULTS: Using the Framingham equation adapted for Navarra (ie, the RICORNA or Riesgo Coronario Navarra), the proportion with an estimated probability of a coronary event in the next 10 years greater than 9% is approximately half that in the original Framingham population, and the proportion with a high or very high probability (ie, 20%) is one-third. An HDL-C level <35 mg/dL increases the risk by 50% and a level =60 mg/dL reduces it by 50%, approximately. The average HDL-C level observed in the population was 63.9 mg/dL overall, and 70.1 mg/dL in women.

CONCLUSIONS: The RICORNA equation can provide a more precise estimate of overall coronary risk and could be useful in primary disease prevention in Navarra. The high HDL-C concentration observed in Navarra might contribute to the associated low coronary morbidity and mortality.

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