Sheffield table for primary prevention of coronary heart disease: women |
Showing serum cholesterol concentration conferring an estimated risk of coronary
events of 3.0% per year
Women: Cholesterol concentration (mmol/L)
| Hypertension Smoking Diabetes LVH on ECG** |
Yes Yes Yes Yes |
Yes No Yes Yes |
Yes Yes No Yes |
Yes Yes Yes No |
Yes No No Yes |
No Yes Yes No |
Yes No Yes No |
Yes Yes No No |
No No Yes No |
No Yes No No |
Yes No No No |
No No No No |
| Age (years) | ||||||||||||
| 70 | 5.5 | 5.5 | 5.5 | 5.8 | 6.3 | 6.9 | 8.5 | 9.8 | ||||
| 68 | 5.5 | 5.5 | 5.5 | 5.8 | 6.4 | 7.0 | 8.6 | 9.9 | ||||
| 66 | 5.5 | 5.5 | 5.5 | 5.9 | 6.5 | 7.1 | 8.7 | 10.0 | ||||
| 64 | 5.5 | 5.5 | 5.5 | 6.1 | 6.6 | 7.2 | 8.9 | |||||
| 62 | 5.5 | 5.5 | 5.5 | 6.2 | 6.8 | 7.4 | 9.1 | |||||
| 60 | 5.5 | 5.5 | 5.5 | 6.4 | 7.0 | 7.7 | 9.4 | |||||
| 58 | 5.5 | 5.5 | 5.5 | 6.7 | 7.3 | 8.0 | 9.8 | |||||
| 56 | 5.5 | 5.5 | 5.5 | 7.0 | 7.7 | 8.4 | ||||||
| 54 | 5.5 | 5.5 | 5.5 | 7.4 | 8.1 | 8.9 | ||||||
| 52 | 5.5 | 5.5 | 5.9 | 7.9 | 8.7 | 9.4 | ||||||
| 50 | 5.5 | 5.5 | 6.4 | 8.5 | 9.3 | |||||||
| 48 | 5.5 | 6.0 | 6.9 | 9.3 | ||||||||
| 46 | 5.5 | 6.7 | 7.7 | |||||||||
| 44 | 5.5 | 7.5 | 8.6 | |||||||||
| 42 | 5.8 | 8.5 | 9.8 | |||||||||
| 40 | 6.7 | 9.9 | ||||||||||
| 38 | 8.0 | |||||||||||
| 36 | 9.7 | |||||||||||
| less than 35 | ||||||||||||
| Hypertension Smoking Diabetes LVH on ECG** |
Yes Yes Yes Yes |
Yes No Yes Yes |
Yes Yes No Yes |
Yes Yes Yes No |
Yes No No Yes |
No Yes Yes No |
Yes No Yes No |
Yes Yes No No |
No No Yes No |
No Yes No 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.
Bradley Cheek 1999
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