|10-Year Absolute Risk Category||Definition of Category|
|High risk||CHD⁎, CHD risk equivalents†including 2+ major risk factors‡plus a 10-year risk for hard CHD greater than 20%§|
|Moderately high risk||2+ major risk factors‡plus a 10-year risk for hard CHD 10% to 20%|
|Moderate risk||2+ major risk factors plus a 10-year risk for hard CHD less than 10%|
|Lower risk||0 to 1 major risk factor (10-year risk for hard CHD usually less than 10%)§|
BP = blood pressure; CHD = coronary heart disease; HDL = high-density lipoprotein.
↵⁎ CHD includes history of myocardial infarction, unstable angina, stable angina, coronary artery procedures (angioplasty or by-pass surgery), or evidence of clinically significant myocardial ischemia.
↵† CHD risk equivalents include clinical manifestations of non-coronary forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, and carotid artery disease [transient ischemic attacks or stroke of carotid origin or greater than 50% obstruction of a carotid artery]), diabetes, and 2+ risk factors with 10-year risk for hard CHD less than 20%.
↵‡ Major risk factors include cigarette smoking, hypertension (BP greater than or equal to 140/90 mm Hg or on antihypertensive medication), low HDL cholesterol (less than 40 mg/dL), family history of premature CHD (CHD in male first-degree relative less than 55 years; CHD in female first-degree relative less than 65 years), and age (men greater than or equal to 45 years; women greater than or equal to 55 years).
↵§ Almost all people with 0 to 1 risk factor have a 10-year risk less than 10%, and 10-year risk assessment in people with 0 to 1 risk factor is thus not necessary. Modified with permission from Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004;110:227–39 (16).