Trends in predicted 10-year risk of coronary heart disease and cardiovascular disease among U.S. adults from 1999 to 2010

Abstract

Objectives: The objective of this study was to examine trends in predicted 10-year risk for coronary heart disease (CHD) and cardiovascular disease (CVD) from 1999 to 2000 and from 2009 to 2010 among adults in the United States.

Background: Examining trends in predicted risk for CHD and CVD may offer insights into the direction of cardiovascular health.

Methods: Data from 7,751 fasting participants, ages 30 to 74 years, of 6 consecutive 2-year cycles of the National Health and Nutrition Examination Survey were used. Predicted 10-year risk for CHD and CVD was calculated using risk equations derived from data from the Framingham Heart Study.

Results: Mean predicted 10-year risk for CHD was 7.2% during 1999 to 2000 and 6.5% during 2009 to 2010 (p for linear trend = 0.005), and for CVD it was 9.2% during 1999 to 2000 and 8.7% during 2009 to 2010 (p for linear trend = 0.152). Mean predicted risk for CHD and CVD declined significantly among participants ages 40 to 49 years, 50 to 59 years, 60 to 74 years, and among women. Mean predicted risk for CHD declined significantly among men and whites but nonsignificantly among Mexican Americans (p for linear trend = 0.067). Mean predicted risk increased nonsignificantly among African Americans for both CHD (p for linear trend = 0.063) and CVD (p for linear trend = 0.059). Of the modifiable cardiovascular risk factors included in the risk equations, favorable trends were noted for mean systolic and diastolic blood pressure, mean concentrations of total cholesterol and high-density lipoprotein cholesterol, and smoking status. The prevalence of diabetes mellitus worsened.

Conclusions: Predicted 10-year risk for CHD improved modestly. Reversing the seemingly rising trend in risk among African-American adults should be a high priority.

Figure 1. Projected 10-Year Risk for CHD

Mean (95% confidence interval) projected 10-year risk for (A) coronary heart disease (CHD) and (B) cardiovascular disease for 7,751 adults age 30 to 74 years, by race or ethnicity and survey period, National Health and Nutrition Examination Survey. Mean predicted 10-year risk for CHD among white adults decreased significantly, whereas mean predicted risk for CHD and cardiovascular disease among African-American adults increased nonsignificantly.