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Relative importance of borderline and elevated levels of coronary heart disease risk factors.
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2005 (English)In: Ann Intern Med, ISSN 1539-3704, Vol. 142, no 6, 393-402 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Clinical trials indicate that a sizable proportion of adults have multiple borderline coronary risk factors and may benefit from treatment. OBJECTIVE: To estimate the relative and absolute contributions of borderline and elevated risk factors to the population burden of coronary heart disease (CHD) events. DESIGN: A prospective cohort study and a national cross-sectional survey. SETTING: The Framingham Study and the Third National Health and Nutrition Examination Survey (NHANES III). PARTICIPANTS: White non-Hispanic persons in the Framingham Study and in NHANES III who were between 35 to 74 years of age and had no CHD. MEASUREMENTS: Occurrence of first CHD events according to 5 major CHD risk factors: blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol levels, glucose intolerance, and smoking. Three categories-optimal, borderline, and elevated-were defined for each risk factor per national guidelines. Sex-specific 10-year CHD event rates from the Framingham Study were applied to numbers of at-risk individuals estimated from NHANES III and the 2000 U.S. Census. RESULTS: Twenty-six percent of men and 41% of women had at least 1 borderline risk factor in NHANES III. According to estimates, more than 90% of CHD events will occur in individuals with at least 1 elevated risk factor, and approximately 8% will occur in people with only borderline levels of multiple risk factors. Absolute 10-year CHD risk exceeded 10% in men older than age 45 years who had 1 elevated risk factor and 4 or more borderline risk factors and in those who had at least 2 elevated risk factors. In women, absolute CHD risk exceeded 10% only in those older than age 55 years who had at least 3 elevated risk factors. LIMITATIONS: The generalizability of the findings to persons of other ethnic backgrounds is unknown. CONCLUSIONS: Borderline CHD risk factors alone account for a small proportion of CHD events.

Place, publisher, year, edition, pages
2005. Vol. 142, no 6, 393-402 p.
Keyword [en]
Adult, Age Distribution, Aged, Blood Pressure/physiology, Coronary Disease/*epidemiology/etiology/physiopathology, Cross-Sectional Studies, Female, Glucose Intolerance/complications, Humans, Hypertension/complications, Lipoproteins; HDL Cholesterol/blood, Lipoproteins; LDL Cholesterol/blood, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Distribution, Smoking/adverse effects, United States/epidemiology
URN: urn:nbn:se:uu:diva-72226PubMedID: 15767617OAI: oai:DiVA.org:uu-72226DiVA: diva2:100137
Available from: 2005-05-19 Created: 2005-05-19 Last updated: 2016-01-18

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Sundstrom, Johan
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Department of Public Health and Caring Sciences

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