Coronary Heart Disease
(10-year risk)

(based on Wilson, D'Agostino, Levy et al. 'Prediction of Coronary Heart Disease using Risk Factor Categories', Circulation 1998)

Outcome
Coronary Heart Disease

Duration of follow-up
Maximum of 12 years, 10-year risk prediction

Population of interest
Individuals 30 to 74 years old and without overt CHD at the baseline examination

Predictors

Estimating Risk of CHD in Men
Wilson, PWF, Circulation 1998;97:1837-1847

Step 1
Age
Years LDL Pts Chol Pts
30-34 -1 [-1]
35-39 0 [0]
40-44 1 [1]
45-49 2 [2]
50-54 3 [3]
55-59 4 [4]
60-64 5 [5]
65-69 6 [6]
70-74 7 [7]
 
Step 2
LDL-C
(mg/dl) (mmol/L) LDL Pts
<100 <2.59 -3
100-129 2.60-3.36 0
130-159 3.37-4.14 0
160-190 4.15-4.92 1
≥190 ≥4.92 2
 
Cholesterol
(mg/dl) (mmol/L) Chol Pts
<160 <4.14 [-3]
160-199 4.15-5.17 [0]
200-239 5.18-6.21 [1]
240-279 6.22-7.24 [2]
≥280 ≥7.25 [3]
 
Step 3
HDL-C
(mg/dl) (mmol/L) LDL Pts Chol Pts
<35 <0.90 2 [2]
35-44 0.91-1.16 1 [1]
45-49 1.17-1.29 0 [0]
50-59 1.30-1.55 0 [0]
≥60 ≥1.56 -1 [-2]
 
Step 4
Blood Pressure
Systolic
(mm Hg)
Diastolic (mm Hg)
<80 80-84 85-89 90-99 ≥100
<120 0 [0]pts
120-129 0 [0]pts
130-139 1 [1]pts
140-159 2 [2]pts
≥160 3 [3]pts
 

*Note: When systolic and diastolic pressures provide different estimates for point scores, use the higher number

Step 5
Diabetes
LDL Pts Chol Pts
No 0 [0]
Yes 2 [2]
 
Step 6
Smoker
LDL Pts Chol Pts
No 0 [0]
Yes 2 [2]
 
Step 7 (sum from Steps 1-6)
Adding up the points
Age        
LDL-C or Chol        
HDL-C        
Blood Pressure        
Diabetes        
Smoker        
Point total        
 
Step 8 (determine CHD risk from point total)
CHD Risk
LDL Pts
Total
10 Yr
CHD Risk
Chol Pts
Total
10 Yr
CHD Risk
<-3 1%
-2 2%
-1 2% [<-1] [2%]
0 3% [0] [3%]
1 4% [1] [3%]
2 4% [2] [4%]
3 6% [3] [5%]
4 7% [4] [7%]
5 9% [5] [8%]
6 11% [6] [10%]
7 14% [7] [13%]
8 18% [8] [16%]
9 22% [9] [20%]
10 27% [10] [25%]
11 33% [11] [31%]
12 40% [12] [37%]
13 47% [13] [45%]
≥14 ≥56% [≥14] [≥53%]
 
Step 9 (compare to average person your age)
Comparative Risk
Age
(years)
Average
10 Yr CHD
Risk
Average
10 Yr Hard* CHD
Risk
Low**
10 Yr CHD
Risk
30-34 3% 1% 2%
35-39 5% 4% 3%
40-44 7% 4% 4%
45-49 11% 8% 4%
50-54 14% 10% 6%
55-59 16% 13% 7%
60-64 21% 20% 9%
65-69 25% 22% 11%
70-74 30% 25% 14%
 
Key
Color Relative Risk
green Very low
green-yellow Low
yellow Moderate
yellow-red High
red Very high
 

*Hard CHD events exclude angina pectoris

**Low risk was calculated for a person the same age, optimal blood pressure, LDL-C 100-129mg/dl or cholesterol 160-199 mg/dl, HDL-C 45 mg/dl for men or 55 mg/dl for women, non-smoker, no diabetes.

Risk estimates were derived from the experience of the Framingham Heart Study, a predominantly Caucasian population in Massachusetts, USA.

Estimating Risk of CHD in Women
Wilson, PWF, Circulation 1998;97:1837-1847

Step 1
Age
Years LDL Pts Chol Pts
30-34 -9 [-9]
35-39 -4 [-4]
40-44 0 [0]
45-49 3 [3]
50-54 6 [6]
55-59 7 [7]
60-64 8 [8]
65-69 8 [8]
70-74 8 [8]
 
Step 2
LDL-C
(mg/dl) (mmol/L) LDL Pts
<100 <2.59 -2
100-129 2.60-3.36 0
130-159 3.37-4.14 0
160-190 4.15-4.92 2
≥190 ≥4.92 2
 
Cholesterol
(mg/dl) (mmol/L) LDL Pts
<160 <4.14 [-2]
160-199 4.15-5.17 [0]
200-239 5.18-6.21 [1]
240-279 6.22-7.24 [1]
≥280 ≥7.25 [3]
 
Step 3
HDL-C
(mg/dl) (mmol/L) LDL Pts Chol Pts
<35 <0.90 5 [5]
35-44 0.91-1.16 2 [2]
45-49 1.17-1.29 1 [1]
50-59 1.30-1.55 0 [0]
≥60 ≥1.56 -2 [-3]
 
Step 4
Blood Pressure
Systolic
(mm Hg)
Diastolic (mm Hg)
<80 80-84 85-89 90-99 ≥100
<120 -3 [-3]pts
120-129 0 [0]pts
130-139 0 [0]pts
140-159 2 [2]pts
≥160 3 [3]pts
 

*Note: When systolic and diastolic pressures provide different estimates for point scores, use the higher number

Step 5
Diabetes
LDL Pts Chol Pts
No 0 [0]
Yes 4 [4]
 
Step 6
Smoker
LDL Pts Chol Pts
No 0 [0]
Yes 2 [2]
 
Step 7 (sum from Steps 1-6)
Adding up the points
Age        
LDL-C or Chol        
HDL-C        
Blood Pressure        
Diabetes        
Smoker        
Point total        
 
Step 8 (determine CHD risk from point total)
CHD Risk
LDL Pts
Total
10 Yr
CHD Risk
Chol Pts
Total
10 Yr
CHD Risk
≤-2 1% [≤-2] [1%]
-1 2% [-1] [2%]
0 2% [0] [2%]
1 2% [1] [2%]
2 3% [2] [3%]
3 3% [3] [3%]
4 4% [4] [4%]
5 5% [5] [4%]
6 6% [6] [5%]
7 7% [7] [6%]
8 8% [8] [7%]
9 9% [9] [8%]
10 11% [10] [10%]
11 13% [11] [11%]
12 15% [12] [13%]
13 17% [13] [15%]
13 17% [13] [15%]
14 20% [14] [18%]
15 24% [15] [20%]
16 27% [16] [24%]
≥17 ≥32% [≥17] [≥27%]
 
Step 9 (compare to average person your age)
Comparative Risk
Age
(years)
Average
10 Yr CHD
Risk
Average
10 Yr Hard* CHD
Risk
Low**
10 Yr CHD
Risk
30-34 <1% <1% <1%
35-39 <1% <1%% 1%
40-44 2% 1% 2%
45-49 5% 2% 3%
50-54 8% 3% 5%
55-59 12% 7% 7%
60-64 12% 8% 8%
65-69 13% 8% 8%
70-74 14% 11% 8%
 
Key
Color Relative Risk
green Very low
green-yellow Low
yellow Moderate
yellow-red High
red Very high
 

*Hard CHD events exclude angina pectoris

**Low risk was calculated for a person the same age, optimal blood pressure, LDL-C 100-129mg/dl or cholesterol 160-199 mg/dl, HDL-C 45 mg/dl for men or 55 mg/dl for women, non-smoker, no diabetes.

Risk estimates were derived from the experience of the Framingham Heart Study, a predominantly Caucasian population in Massachusetts, USA.

Functions for Men and Women

Estimated Coefficients Underlying CHD
Prediction Sheets Using Total Cholesterol Categories
Variable Men Women
Age,-y 0.04826 0.33766
Age-squared,-y -0.00268
TC,-mg/dL
<160 -0.65945 -0.26138
160-199 Referent Referent
200-239 0.17692 0.20771
240-279 0.50539 0.24385
>=280 0.65713 0.53513
HDL-C,-mg/dL
<35 0.49744 0.84312
35-44 0.2431 0.37796
45-49 Referent 0.19785
50-59 -0.05107 Referent
>=60 -0.4866 -0.42951
Blood-pressure
Optimal -0.00226 -0.53363
Normal Referent Referent
High-normal 0.2832 -0.06773
Stage-I-hypertension 0.52168 0.26288
Stage-II-IV-hypertension 0.61859 0.46573
Diabetes 0.42839 0.59626
Smoker 0.52337 0.29246
Baseline-survival-function-at-10-years, S0(10) 0.90015 0.96246
Linear predictor at risk factor means 3.09750 9.92545
 
Estimated Coefficients Underlying CHD
Prediction Sheets Using LDL Cholesterol Categories
Variable Men Women
Age,-y 0.04808 0.33994
Age-squared,-y -0.0027
LDL-C,-mg/dL
<100 -0.69281 -0.42616
100-129 Referent Referent
130-159 0.00389 0.01366
160-189 0.26755 0.26948
≥190 0.56705 0.33251
HDL-C,-mg/dL
<35 0.48598 0.88121
35-44 0.21643 0.36312
45-49 Referent 0.19247
50-59 -0.0471 Referent
≥60 -0.3419 -0.35404
Blood-pressure
Optimal -0.02642 -0.51204
Normal Referent Referent
High-normal 0.30104 -0.03484
Stage-I-hypertension 0.55714 0.28533
Stage-II-IV hypertension 0.65107 0.50403
Diabetes 0.42146 0.61313
Smoker 0.54377 0.29737
Baseline-survival-function-at-10-years, S0(10) 0.90017 0.9628
Linear predictor at risk factor means 3.00069 9.91414