(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
- Age
- Diabetes
- Smoking
- JNC-V blood pressure categories
- NCEP total cholesterol categories
- LDL cholesterol categories
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 |
| white |
Low |
| yellow |
Moderate |
| rose |
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 |
| white |
Low |
| yellow |
Moderate |
| rose |
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 |
