Validating the framingham hypertension risk score: Results from the whitehall II study

Mika Kivimäki, G. David Batty, Archana Singh-Manoux, Jane E. Ferrie, Adam G. Tabak, Markus Jokela, Michael G. Marmot, George Davey Smith, Martin J. Shipley

Research output: Contribution to journalArticle

45 Citations (Scopus)


A promising hypertension risk prediction score using data from the US Framingham Offspring Study has been developed, but this score has not been tested in other cohorts. We examined the predictive performance of the Framingham hypertension risk score in a European population, the Whitehall II Study. Participants were 6704 London-based civil servants aged 35 to 68 years, 31% women, free from prevalent hypertension, diabetes mellitus, and coronary heart disease. Standard clinical examinations of blood pressure, weight and height, current cigarette smoking, and parental history of hypertension were undertaken every 5 years for a total of 4 times. We recorded a total of 2043 incident (new-onset) cases of hypertension in three 5-year baseline follow-up data cycles. Both discrimination (C statistic: 0.80) and calibration (Hosmer-Lemeshow χ2: 11.5) of the Framingham hypertension risk score were good. Agreement between the predicted and observed hypertension incidences was excellent across the risk score distribution. The overall predicted:observed ratio was 1.08, slightly better among individuals >50 years of age (0.99 in men and 1.02 in women) than in younger participants (1.16 in men and 1.18 in women). Reclassification with a modified score on the basis of our study population did not improve the prediction (net reclassification improvement: -0.5%; 95% CI: -2.5% to 1.5%). These data suggest that the Framingham hypertension risk score provides a valid tool with which to estimate near-term risk of developing hypertension.

Original languageEnglish
Pages (from-to)496-501
Number of pages6
Issue number3
Publication statusPublished - Sep 1 2009


  • Hypertension
  • Prevention
  • Primary prevention
  • Public health
  • Risk assessment
  • Risk factors

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint Dive into the research topics of 'Validating the framingham hypertension risk score: Results from the whitehall II study'. Together they form a unique fingerprint.

  • Cite this

    Kivimäki, M., Batty, G. D., Singh-Manoux, A., Ferrie, J. E., Tabak, A. G., Jokela, M., Marmot, M. G., Smith, G. D., & Shipley, M. J. (2009). Validating the framingham hypertension risk score: Results from the whitehall II study. Hypertension, 54(3), 496-501.