BACKGROUND: Current cholesterol guidelines recommend using 10-year risk of atherosclerotic cardiovascular disease (ASCVD) to guide informed decisions regarding statin therapy, yet patients may have difficulty conceptualizing absolute risk estimates. Peer comparisons may provide an improved tool for patient risk comprehension. METHODS: Using data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES), we estimated standardized risk percentiles for various age-, sex-, and race-specific subgroups based on their 10-year ASCVD risks using the Pooled Cohort Equations. RESULTS: We examined 9160 adults in NHANES who were free of cardiovascular disease and had complete clinical data. Among specific age, sex, and race groups, we estimated the distribution of 10-year risk, calculating the 10-year risk corresponding to each percentile in order to generate standardized cardiovascular risk percentiles. Estimated 10-year ASCVD absolute risk varied markedly by age, sex, and race subgroups. A 10-year risk of 7.0% would put a 55 year-old black male in the 20th percentile relative to his peers (ie, at lower risk than 80% of his peers), whereas a 10-year risk of 7.0% would put a 55 year-old white female in the 95th percentile (i.e., only 5% of her peers would have higher risk). Standardized cardiovascular risk percentiles by age, race, and sex are available online at populationrelativerisk.dcri.org. CONCLUSION: Cardiovascular risk varies substantially by age, sex, and race. These data allow for 10-year absolute risks of ASCVD to be translated into a standardized cardiovascular risk percentile, providing patients with information that is easy to understanding regarding how their personal risk of cardiovascular disease compares with their age-, sex-, and race-matched peers.
BACKGROUND: Current cholesterol guidelines recommend using 10-year risk of atherosclerotic cardiovascular disease (ASCVD) to guide informed decisions regarding statin therapy, yet patients may have difficulty conceptualizing absolute risk estimates. Peer comparisons may provide an improved tool for patient risk comprehension. METHODS: Using data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES), we estimated standardized risk percentiles for various age-, sex-, and race-specific subgroups based on their 10-year ASCVD risks using the Pooled Cohort Equations. RESULTS: We examined 9160 adults in NHANES who were free of cardiovascular disease and had complete clinical data. Among specific age, sex, and race groups, we estimated the distribution of 10-year risk, calculating the 10-year risk corresponding to each percentile in order to generate standardized cardiovascular risk percentiles. Estimated 10-year ASCVD absolute risk varied markedly by age, sex, and race subgroups. A 10-year risk of 7.0% would put a 55 year-old black male in the 20th percentile relative to his peers (ie, at lower risk than 80% of his peers), whereas a 10-year risk of 7.0% would put a 55 year-old white female in the 95th percentile (i.e., only 5% of her peers would have higher risk). Standardized cardiovascular risk percentiles by age, race, and sex are available online at populationrelativerisk.dcri.org. CONCLUSION: Cardiovascular risk varies substantially by age, sex, and race. These data allow for 10-year absolute risks of ASCVD to be translated into a standardized cardiovascular risk percentile, providing patients with information that is easy to understanding regarding how their personal risk of cardiovascular disease compares with their age-, sex-, and race-matched peers.
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Authors: Paul K Whelton; Robert M Carey; Wilbert S Aronow; Donald E Casey; Karen J Collins; Cheryl Dennison Himmelfarb; Sondra M DePalma; Samuel Gidding; Kenneth A Jamerson; Daniel W Jones; Eric J MacLaughlin; Paul Muntner; Bruce Ovbiagele; Sidney C Smith; Crystal C Spencer; Randall S Stafford; Sandra J Taler; Randal J Thomas; Kim A Williams; Jeff D Williamson; Jackson T Wright Journal: Hypertension Date: 2017-11-13 Impact factor: 10.190
Authors: Lyndal J Trevena; Brian J Zikmund-Fisher; Adrian Edwards; Wolfgang Gaissmaier; Mirta Galesic; Paul K J Han; John King; Margaret L Lawson; Suzanne K Linder; Isaac Lipkus; Elissa Ozanne; Ellen Peters; Danielle Timmermans; Steven Woloshin Journal: BMC Med Inform Decis Mak Date: 2013-11-29 Impact factor: 2.796
Authors: Ann Marie Navar; Tracy Y Wang; Xiaojuan Mi; Jennifer G Robinson; Salim S Virani; Veronique L Roger; Peter W F Wilson; Anne C Goldberg; Eric D Peterson Journal: JAMA Cardiol Date: 2018-12-01 Impact factor: 14.676
Authors: Ann Marie Navar; Tracy Y Wang; Shuang Li; Xiaojuan Mi; Zhuokai Li; Jennifer G Robinson; Salim S Virani; Eric D Peterson Journal: Circ Cardiovasc Qual Outcomes Date: 2021-01-13