The distribution of 10-year risk for coronary heart disease among US adults - Findings from the National Health and Nutrition Examination Survey III

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. (C) 2004 by the American College of Cardiology Foundation.