Sheffield table for primary prevention of coronary heart disease: men

Showing serum cholesterol concentration conferring an estimated risk of coronary events of 3.0% per year

• The Sheffield table
• Instructions for use
• Notes on use of table
• References

Men: Cholesterol concentration (mmol/L)

Hypertension Smoking Diabetes LVH on ECG**	Yes Yes Yes Yes	Yes Yes No Yes	Yes No Yes Yes	Yes No No Yes	Yes Yes Yes No	No Yes Yes No	Yes Yes No No	Yes No Yes No	No Yes No No	No No Yes No	Yes No No No	No No No No
Age (years)
70	5.5	5.5	5.5	5.5	5.5	5.5	5.5	5.5	5.5	6.0	6.5	7.7
68	5.5	5.5	5.5	5.5	5.5	5.5	5.5	5.5	5.6	6.4	6.9	8.2
66	5.5	5.5	5.5	5.5	5.5	5.5	5.5	5.7	5.9	6.8	7.3	8.7
64	5.5	5.5	5.5	5.5	5.5	5.5	5.5	6.1	6.3	7.3	7.8	9.3
62	5.5	5.5	5.5	5.5	5.5	5.5	5.6	6.5	6.7	7.8	8.3
60	5.5	5.5	5.5	5.5	5.5	5.6	6.0	6.9	7.2	8.3	8.9
58	5.5	5.5	5.5	5.5	5.5	6.1	6.5	7.4	7.7	8.9
56	5.5	5.5	5.5	5.5	5.5	6.5	7.0	8.0	8.3
54	5.5	5.5	5.5	5.5	5.9	7.0	7.5	8.6	9.0
52	5.5	5.5	5.5	5.5	6.3	7.6	8.1	9.3
50	5.5	5.5	5.5	5.7	6.9	8.2	8.8
48	5.5	5.5	5.5	6.2	7.5	8.9
46	5.5	5.5	5.5	6.8	8.2
44	5.5	5.5	5.8	7.4	9.0
42	5.5	5.6	6.4	8.2
40	5.5	6.1	7.1	9.0
38	5.5	6.8	7.9
36	6.0	7.6	8.8
34	6.7	8.6
32	7.6
30	8.7
less than 29
Hypertension Smoking Diabetes LVH on ECG**	Yes Yes Yes Yes	Yes Yes No Yes	Yes No Yes Yes	Yes No No Yes	Yes Yes Yes No	No Yes Yes No	Yes Yes No No	Yes No Yes No	No Yes No No	No No Yes No	Yes No No No	No No No No

**HYPERTENSIVE SUBJECTS ONLY

Instructions

• Choose the table for men or women
• Identify the correct column for smoking, hypertension and diabetes
• In normotensive subjects assume LVH absent. In those with hypertension, LVH is diagnosed by ECG showing increased voltage and flat or inverted T waves in the left precordial leads. If no ECG is available, assume LVH is absent.
• Identify the row showing the age of the subject
• Read off the cholesterol concentration at the intersection of the appropriate column and row:
  
  • If there is no entry, cholesterol need not be measured
  • If there is an entry, measure serum cholesterol
  • If the average cholesterol on repeated measurement is at or above the level shown, the CHD event risk is 3.0% per year consider treatment

The table can be used to look forward to need for measurement or treatment at an older age

LVH = left ventricular hypertrophy;
CHD = coronary heart disease;
ECG - electrocardiograph

Notes on use of table

• Do not use for decisions on secondary prevention : patients with myocardial infarct, angina, peripheral vascular disease, or symptomatic carotid disease already have high CHD risk
  At this risk (3% events per year) treatment with a statin (but not necessarily other drug classes) is justifiable
• Use the table after appropriate advice on smoking, diet, and control of systolic blood pressure to < 160 mm Hg
• Use the average of two or more cholesterol concentrations
• The table may underestimate CHD risk in some individuals:
  • British Asians
  • those with low HDL cholesterol
  • those with very strong family history of premature CHD
  • those with familial hyperlipidaemia

References:

Haq IU et al. Lancet 1995, 346: 1467-71.
Ramsay LE et al. Lancet 1996, 348: 387-88.
Haq IU et al. Clin Sci 1996, 91: 399-413.

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Bradley Cheek 1998

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