AHA/ACC Scientific Statement:Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations

Table of Contents	Print a PDF	References	Figures & Tables
<Previous		Next >

GRUNDY ET AL., Assessment of Cardiovascular Risk
J Am Coll Cardiol 1999;34:1348--59

AHA/ACC Scientific Statement: Assessment of Cardiovascular Risk by Use of Multiple-Risk-Factor Assessment Equations

A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology

VI. Definition of Low Risk

The Framingham report² defined low risk as the risk for CHD at any age that is conferred by a combination of all the following parameters: blood pressure <120/<80 mm Hg, total cholesterol 160 to 199 mg/dL (or LDL-C 100 to 129 mg/dL), and HDL-C >45 mg/dL for men or >55 mg/dL for women in a nonsmoking person with no diabetes (Table 3). This definition of low risk seems appropriate and should be widely applicable; for example, in the follow-up of 350 000 screenees of the Multiple Risk Factor Intervention Trial,¹⁶ most of the excess mortality from CHD could be explained by the presence of the major risk factors above these levels. The NCEP⁶ designated a total cholesterol level of <200 mg/dL (or LDL-C of <130 mg/dL) as a desirable level. Framingham investigators² included total cholesterol levels in the range of 160 to 199 mg/dL (and LDL-C of 100 to 129 mg/dL) in their definition of the low-risk state. In addition, NCEP⁶ recognized an LDL-C level of <100 mg/dL as optimal and as the goal of therapy for secondary prevention. This level corresponds to a total cholesterol level of ~<160 mg/dL. An elevated LDL-C level appears to be the primary CHD risk factor, because some elevation of LDL seems to be necessary for the development of coronary atherosclerosis.¹⁷ A very-low-risk state can be defined as an LDL-C level of <100 mg/dL in the presence of other low-risk parameters (Table 3). Therapeutic efforts to reestablish a very-low-risk state appear to be justified for secondary prevention;^1,6 in primary prevention, however, a very low LDL-C level is not currently deemed necessary.⁶

American College of Cardiology

Helping Cardiovascular Professionals Learn. Advance. Heal.

GRUNDY ET AL., Assessment of Cardiovascular Risk J Am Coll Cardiol 1999;34:1348--59