Original ArticleThe population effects of the global cardiovascular risk model in United States Adults: Findings from the National Health and Nutrition Surveys, 2005–2006
Section snippets
Methods
The National Center for Health Statistics performs the National Health and Nutrition Examination Survey (NHANES) surveys7 in 2-year increments with the objective being to define the health and nutritional status of the United States population. The NHANES surveys are composed of a home health interview and a health examination that is performed in a mobile exam center (MEC). Participants undergo a home interview process administered by a trained interviewer. Subsequently, participants undergo
Men
A total of 663 men representing 32.8 million U.S. men ages 45–74 met inclusion criteria. The mean age of the included men was 55.1 years (SD 7.9 years), mean LDL-C was 120.3 mg/dL (SD 37.3), mean systolic blood pressure was 125.4 mmHg (SD 16.1 mmHg), mean diastolic blood pressure was 73.8 mmHg (SD 11.2 mmHg), mean HDL was 50.5 mg/dL (SD 14.6 mg/dL), and the mean total cholesterol was 204.9 mg/dL (SD 36.2 mg/dL). Of the included male subjects, 26% were tobacco users, 16% had a positive family
Primary findings
The present cross-sectional analysis represents the first report to define risk reclassification distributions and corresponding changes to lipid goal achievements clinicians will encounter if they shift their risk assessment practice from the FRS-CHD to the FRS-CVD for routine cardiovascular risk assessment. Overall there were three significant findings. First, we found with the routine use of the FRS-CVD model nearly two-thirds (63%) of U.S. men aged 45–74 and three-quarters (74%) of U.S.
Conclusions
It remains uncertain whether the ATP IV writing group will continue to recommend multivariate risk assessment, and if so, which risk assessment model should be used. Clinicians, however, should be aware that shifting nationally to routine calculation of global CVD risk does have implications. Use of the FRS-CVD risk assessment model greatly increases both the number of individuals classified as “intermediate risk” (FRS between 6% and 20%), and high risk (FRS ≥20%) while markedly decreasing the
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