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

Abstract

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 13769 participants (representing 157366716 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.