Prediction of coronary heart disease using risk factor categories

The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the d...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1998-05, Vol.97 (18), p.1837-1847
Main Authors: WILSON, P. W. F, D'AGOSTINO, R. B, LEVY, D, BELANGER, A. M, SILBERSHATZ, H, KANNEL, W. B
Format: Article
Language:English
Subjects:
Adult
Aged
Algorithms
Biological and medical sciences
Blood Pressure
Body Mass Index
Cardiology. Vascular system
Cholesterol - blood
Cholesterol, LDL - classification
Cohort Studies
Comorbidity
Coronary Disease - epidemiology
Coronary heart disease
Diabetes Mellitus - epidemiology
Female
Follow-Up Studies
Heart
Humans
Lipids - blood
Male
Medical sciences
Middle Aged
National Health Programs
Proportional Hazards Models
Risk Factors
Smoking - epidemiology
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Summary:The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the discrimination properties of this approach with other noncategorical prediction functions. This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all P or =130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (> or =200 mg/dL) was 27% in men and 34% in women. Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.97.18.1837