Trends in the coronary heart disease risk profile of middle-aged adults

Purpose: To examine recent trends in the coronary heart disease (CHD) risk profiles of the population aged 45 to 64 in the United States. Methods: Data from the National Health and Nutrition Examination Surveys (NHANES) from 2 time periods (1988-1994 and 2005-2008) are used to estimate the CHD risk functions derived from the Framingham Heart Study. The risk functions take account of levels of blood pressure (systolic and diastolic), total and high-density lipoprotein serum cholesterol, diabetes (doctor diagnosed or based on fasting glucose), and smoking status to estimate the 10-year risk of myocardial infarction or coronary death. We estimate the risk functions by gender, race, and age group (45-54 and 55-64). Results: The CHD risk profile of middle-aged adults has improved over time. For example, the mean 10-year risk of heart attack or CHD death among persons 55 to 64 years has declined from 7.1% to 5.2%. Declines are seen among both men and women and among non-Hispanic Blacks and non-Hispanic whites. Conclusions: Despite increases in diabetes and obesity, the CHD risk profile of middle-aged adults improved during the period from 1988-1994 to 2005-2008. Published by Elsevier Inc.