Who exceeds ATP-III risk thresholds? Systematic examination of the effect of varying age and risk factor levels in the ATP-III risk assessment tool.
OBJECTIVE
We sought to determine the levels of risk factors required to exceed threshold values of intermediate (> or = 10%) or high (> 20%) predicted 10-year risk for coronary heart disease using the Adult Treatment Panel III (ATP-III) Risk Assessment Tool.


METHODS
Continuous risk factor values were entered into the risk assessment tool to examine levels of predicted 10-year risk. Both individual risk factors and the joint effects of varying multiple risk factors were systematically examined.


RESULTS
Women only exceed 10% risk at ages > or = 70 with single risk factors of HDL-cholesterol levels < 30 mg/dL or systolic blood pressure > 170 mm Hg. Women < or = 65 only exceed 10% risk if they are smokers with low HDL-cholesterol levels. In contrast, single risk factors can cause men over 45 to exceed 10% or 20% predicted 10-year risk. Combinations of only modestly elevated risk factors cause many men to exceed 10% risk at ages > or = 45, and to exceed 20% risk at ages > or = 55.


CONCLUSIONS
Because such high-risk factor levels are required for men < 45 years and women < 65 years to exceed ATP-III risk thresholds, additional means for risk communication may be needed for individuals with elevated risk factors in these age ranges.
Cavanaugh-Hussey
Margaret W
MW
Johns Hopkins School of Medicine, USA.
Berry
Jarett D
JD
Lloyd-Jones
Donald M
DM
D000328:Adult; D000367:Age Factors; D000368:Aged; D003327:Coronary Disease / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005544:Forecasting; D006801:Humans; D006937:Hypercholesterolemia / Q000145:classification / Q000150:complications*; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000145:classification* / Q000379:methods*; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors