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CLINICAL RESEARCH: CORONARY ARTERY DISEASE

The distribution of 10-Year risk for coronary heart disease among U.S. adults

Findings from the National Health and Nutrition Examination Survey III

^* Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Manuscript received June 30, 2003; revised manuscript received November 24, 2003, accepted November 25, 2003.

^* Reprint requests and correspondence: Dr. Earl S. Ford, Centers for Disease Control and Prevention, 4770 Buford Highway, MS K66, Atlanta, Georgia 30341, USA.
eford{at}cdc.gov

OBJECTIVES: We sought to establish the distribution of the 10-year risk for coronary heart disease (CHD) among U.S. adults.

BACKGROUND: Risk assessment for CHD was developed to provide clinicians with a tool to estimate the absolute risk of developing CHD. More recently, risk assessment is increasingly being incorporated into guidelines for diagnostic testing and treatment. Yet, little is known about the 10-year risk distribution for CHD among adults in the U.S. based on these risk assessment tools.

METHODS: We applied the risk prediction algorithm used by the National Cholesterol Education Program Adult Treatment Panel III guidelines to data from 13,769 participants (representing 157,366,716 U.S. adults) age 20 to 79 years in the Third National Health and Nutrition Examination Survey (1988 to 1994).

RESULTS: Among participants without self-reported CHD (heart attack and angina pectoris), stroke, peripheral vascular disease, and diabetes, 81.7% (140 million adults) had a 10-year risk for CHD of <10%, 15.5% (23 million adults) of 10% to 20%, and 2.9% (4 million adults) of >20%. The proportion of the participants with a 10-year risk for CHD of >20% increased with advancing age and was higher among men than among women but varied little with race or ethnicity.

CONCLUSIONS: Our results help to define the distribution of 10-year risk for CHD among U.S. adults.

Abbreviations and Acronyms   BP = blood pressure   CHD = coronary heart disease   NCEP/ATP III = National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)   NHANES = National Health and Nutrition Examination Survey

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