Abstract 1033: Distribution of 10-Year and Lifetime Predicted Risks for Cardiovascular Disease in U.S. Adults: Findings From the National Health and Nutrition Examination Survey, 2003 to 2006
Background: Most U.S. adults, especially women and younger men, have low 10-year predicted risk for cardiovascular disease (CVD) regardless of risk factor burden. National guidelines endorse consideration of lifetime CVD risk in addition to 10-year risk. However, the current prevalence of low 10-year but high lifetime predicted risks in US adults is unknown.
Methods: We included 6329 nonpregnant NHANES 2003–2006 participants, ages 20 –79 and free of CVD, representing 156 million U.S. adults, to estimate the numbers of US adults in three risk groups: low 10-year (<10%)/low lifetime (<39%), low 10-year/high lifetime (≥39%), and high 10-year (≥10% or diagnosed diabetes) predicted risks. Ten-year risks were estimated using the Framingham risk score; lifetime risks were estimated using a previously published algorithm based on aggregate risk factor burden.
Results: We found that 82% of all US adults have low 10-year CHD predicted risk, but 2/3 of these have high lifetime CVD predicted risk. Thus, 87 million US adults (56%) have low 10-year/high lifetime predicted risk, 41 million (26%) have low 10-year/low lifetime risk, and 28 million (18%) have high 10-year risk. Of note, low 10-year/high lifetime predicted risk is most prevalent in women at all ages and younger men (see Figure⇓).
Conclusions: A substantial proportion of US adults (56%, or 87 million) have low 10-year but high lifetime predicted risks for CVD. These results provide support for use of a stepwise risk stratification system aimed at improving risk communication, and provide a baseline for public health efforts aimed at increasing the proportion of Americans with low short-term and low lifetime risks for CVD.