No abstract

C oronary heart disease (CHD) continues to be the cause of the greatest number of deaths among adult Americans.' Although there is a downward trend in cardiovascular mortality rates, morbidity and mortality rates remain high and are of great concern to clinicians and health officials. Using a simple worksheet, a patient's 5-and 10-year CHD risks can be estimated. The components of the profile were selected because they are objective and strongly and independently related to CHD and because they can be measured through simple office procedures and laboratory results.In The equations presented here have several advantages over previous versions. The data base from which they are derived is larger and more recent. In particular, more data for individuals older than 60 years are available. In addition, the influence of high density lipoprotein (HDL) cholesterol, which has been measured in the Framingham Heart Study since 1968, is reflected in these equations. Measurement of the ratio of total cholesterol to HDL cholesterol has been found to be superior to measurement of serum cholesterol as a predictor of CHD.8At the baseline examination for this study (1968)(1969)(1970)(1971)(1972)(1973)(1974)(1975), all members of the original Framingham cohort were more than 50 years old. To Tables 1-4 detail the crude incidence rates of CHD and the distributions of risk factors among the study population by age. From the experience of this group during a 12-year period, estimates of CHD risk have been produced that reflect the approximate combined impacts of total and HDL cholesterol, SBP or diastolic blood pressure (DBP), cigarette smoking, diabetes mellitus, and LVH as measured by electrocardiography (ECG-LVH).The derivation and uses of the worksheet are detailed in the remainder of this article. Methods Population and Risk FactorsEvery member of the original and offspring cohorts who met three basic criteria were included in the study. Requirements for inclusion were 1) age 30-74 years at the time of the baseline examination; 2) measurements available for SBP and DBP, cigarette smoking status, total and HDL cholesterol, and diagnoses (yes or no) of diabetes and ECG-LVH (when information on diabetes or LVH was not available, diagnoses were presumed to be negative); and 3) freedom from cardiovascular disease (stroke, transient ischemia, CHD [includes angina pectoris, coronary insufficiency (unstable angina), myocardial infarction, and sudden death], congestive heart failure, and intermittent claudication) until time of risk factor measurement.Definitions of risk factors and end points are those

Fluctuations in body weight may have negative health consequences, independent of obesity and the trend of body weight over time.