Nutrition Action Healthletter
What's Your Ten-Year Heart Attack Risk?

To estimate your risk of having a heart attack over the next ten years, add up your points for age, total cholesterol, smoking status, HDL, and systolic blood pressure (the higher number).  But be careful how you interpret that risk.

1. Don’t forget your long-term risk.
Estimating your ten-year risk is useful, but it’s not the only thing that matters.

    “You can have a low ten-year risk, but a high long-term risk,” explains James Cleeman, head of the National Cholesterol Education Program (NCEP). “For example, a 35-year-old with high cholesterol and no other risk factors has a low risk of having a heart attack during the next ten years. But there’s no question that the high cholesterol can cause tremendous problems in 30 or 40 years,” says Cleeman.

2. Don’t let points mislead you.
As you get older, smoking and high cholesterol saddle you with fewer points. But that doesn’t mean that it’s safe to smoke or have high cholesterol as you age.

    “You can’t gauge the importance of a risk factor by the number of points,” says Cleeman. “Although the relative risk for smoking and having high cholesterol goes down with age, the absolute risk goes up.”

    In other words, smoking and high cholesterol put you at much higher risk relative to other people your age when you’re young. But when you’re older, your actual, or absolute, risk of having a heart attack is so high that each additional point makes a big difference.

3. Don’t expect 100 percent accuracy.
“Like all risk assessment tools, this one isn’t perfect,” says Cleeman. To get the best read on your risk, use an average of at least two fasting blood samples for your total cholesterol and HDL, and an average of several blood pressure readings.

    And don’t be misled by the use of total (not LDL) cholesterol. The risk assessment uses total cholesterol because it’s based on the Framingham Heart Study, which had better data for total cholesterol than for LDL.

Women
Age Points Age Points
20-34 -7 55-59 8
35-39 -3 60-64 10
40-44 0 65-69 12
45-49 3 70-74 14
50-54 6 75-79 16

Total Cholesterol
(mg/dL)
Points
Age
20-39
Age
40-49
Age
50-59
Age
60-69
Age
70-79
below 160 0 0 0 0 0
160-199 4 3 2 1 1
200-239 8 5 4 2 1
240-279 11 8 5 3 2
280 or more 13 10 7 4 2

Smoking Points
Age
20-39
Age
40-49
Age
50-59
Age
60-69
Age
70-79
Non-Smoker 0 0 0 0 0
Smoker 9 7 4 2 1

HDL (mg/dL) Points HDL (mg/dL) Points
60 or more -1 40-49 1
50-59 0 below 40 2

Systolic Blood
Pressure (mmHg)
If Untreated If Treated
below 120 0 0
120-129 1 3
130-139 2 4
140-159 3 5
160 or more 4 6

Men
Age Points Age Points
20-34 -9 55-59 8
35-39 -4 60-64 10
40-44 0 65-69 11
45-49 3 70-74 12
50-54 6 75-79 13

Total Cholesterol
(mg/dL)
Points
Age
20-39
Age
40-49
Age
50-59
Age
60-69
Age
70-79
below 160 0 0 0 0 0
160-199 4 3 2 1 1
200-239 7 5 3 1 1
240-279 9 6 4 2 1
280 or more 11 8 5 3 1

Smoking Points
Age
20-39
Age
40-49
Age
50-59
Age
60-69
Age
70-79
Non-Smoker 0 0 0 0 0
Smoker 8 5 3 1 1

HDL (mg/dL) Points HDL (mg/dL) Points
60 or more -1 40-49 1
50-59 0 below 40 2

Systolic Blood
Pressure (mmHg)
If Untreated If Treated
below 120 0 0
120-129 0 1
130-139 1 2
140-159 1 2
160 or more 2 3

Risk
Point Total 10-Yr Risk (%)
less than 9 less than 1
9 1
10 1
11 1
12 1
13 2
14 2
15 3
16 4
17 5
18 6
19 8
20 11
21 14
22 17
23 22
24 27
25 or more 30 or more
Risk
Point Total 10-Yr Risk (%)
less than 9 less than 1
0 1
1 1
2 1
3 1
4 1
5 2
6 2
7 3
8 4
9 5
10 6
11 8
12 10
13 12
14 16
15 20
16 25
17 or more 30 or more
Nutrition Action Healthletter Center for Science in the Public Interest October 2001 U.S. Edition To calculate your ten-year heart disease risk online, go to Subscribe Today! Customer Service