Cardiovascular Risk Assessment (10-year, ACC/AHA 2013)

 

Input
 

Race	African American
	White
	Other (see notes
Sex	Female
	Male
Age		mo yr
Total Cholesterol		mg/dL mmol/L
HDL Cholesterol		mg/dL mmol/L
Systolic Blood Pressure		Pascal atm bar cmH2O cmHg ftH2O gm/sqcm inH2O inHg kPa mbar mmHg psi torr
On Hypertension Med	No
	Yes
Diabetes	No
	Yes
Smoker	No
	Yes

 

Results
 

Ten Year Risk		% fraction ratio
Decimal Precision   0 1 2 3

 

 

Notes

• This calculator helps predict the 10-year risk of the following hard ASCVD events:
  • First occurrence of nonfatal myocardial infarction
  • CHD death
  • Fatal or nonfatal stroke
• This calculator may overestimate risk (see Lancet reference) and a discussion with the patient needs to ensue if there are any questions.
• Risk estimates were developed from cohorts primarily comprising White and African American subjects. Risk may be underestimated in American Indians, Asian Americans of South Asian ancestry, and Puerto Ricans. Risk may be overestimated in Asian Americans of East Asian ancestry and some Mexican Americans.

 
Equations used
 

Terms = (CAge * ln(Age)) + (CSqAge * sq(ln(Age))) + (CTotalChol * ln(TotalCholesterol)) + (CAgeTotalChol * ln(Age) * ln(TotalCholesterol)) + (CHDLChol * ln(HDLCholesterol)) + (CAgeHDLChol * ln(Age) * ln(HDLCholesterol)) + (OnHypertensionMed * COnHypertensionMeds * ln(SystolicBloodPressure)) + (OnHypertensionMed * CAgeOnHypertensionMeds * ln(Age) * ln(SystolicBloodPressure)) + (!OnHypertensionMed * COffHypertensionMeds * ln(SystolicBloodPressure)) + (!OnHypertensionMed * CAgeOffHypertensionMeds * ln(Age) * ln(SystolicBloodPressure)) + (CSmoker * Smoker) + (CAgeSmoker * ln(Age) * Smoker) + (CDiabetes * Diabetes)

TenYearRisk = 100 * (1 - S10e(Terms-MeanTerms))

 

Calculation Details and Variables

• For Black or African American female patients CAge = 17.114; CSqAge = 0; CTotalChol = 0.94; CAgeTotalChol = 0; CHDLChol = -18.92; CAgeHDLChol = 4.475; COnHypertensionMeds = 29.291; CAgeOnHypertensionMeds = -6.432; COffHypertensionMeds = 27.82; CAgeOffHypertensionMeds = -6.087; CSmoker = 0.691; CAgeSmoker = 0; CDiabetes = 0.874; S10 = 0.9533; MeanTerms = 86.61.
• For White or other race female patients CAge = -29.799; CSqAge = 4.884; CTotalChol = 13.54; CAgeTotalChol = -3.114; CHDLChol = -13.578; CAgeHDLChol = 3.149; COnHypertensionMeds = 2.019; CAgeOnHypertensionMeds = 0; COffHypertensionMeds = 1.957; CAgeOffHypertensionMeds = 0; CSmoker = 7.574; CAgeSmoker = -1.665; CDiabetes = 0.661; S10 = 0.9665; MeanTerms = -29.18.
• For Black or African American male patients CAge = 2.469; CSqAge = 0; CTotalChol = 0.302; CAgeTotalChol = 0; CHDLChol = -0.307; CAgeHDLChol = 0; COnHypertensionMeds = 1.916; CAgeOnHypertensionMeds = 0; COffHypertensionMeds = 1.809; CAgeOffHypertensionMeds = 0; CSmoker = 0.549; CAgeSmoker = 0; CDiabetes = 0.645; S10 = 0.8954; MeanTerms = 19.54.
• For White or other race male patients CAge = 12.344; CSqAge = 0; CTotalChol = 11.853; CAgeTotalChol = -2.664; CHDLChol = -7.99; CAgeHDLChol = 1.769; COnHypertensionMeds = 1.797; CAgeOnHypertensionMeds = 0; COffHypertensionMeds = 1.764; CAgeOffHypertensionMeds = 0; CSmoker = 7.837; CAgeSmoker = -1.795; CDiabetes = 0.658; S10 = 0.9144; MeanTerms = 61.18.

 

References

1. Goff DC Jr, Lloyd-Jones DM, Bennett G, et.al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013 Nov 12. PubMed ID: 24222018
2. Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013 Nov 12. PubMed ID: 24222016
3. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013 Nov 30;382(9907):1762-5. doi: 10.1016/S0140-6736(13)62388-0. Epub 2013 Nov 20. PubMed ID: 24268611
4. Downs J, Good C. New Cholesterol Guidelines: Has Godot Finally Arrived? Ann Intern Med. 2014 Jan 28. doi: 10.7326/M13-2850. PubMed ID: 24473934
5. Vaishnava P, Eagle KA. ACP Journal Club. ACC/AHA, Adult Treatment Panel III, and ESC guidelines overestimated risk for CVD in older adults. Ann Intern Med. 2014 Aug 19;161(4):JC13. PubMed ID: 25133380
6. Kavousi M, Leening MJ, Nanchen D, et al. Comparison of Application of the ACC/AHA Guidelines, Adult Treatment Panel III Guidelines, and European Society of Cardiology Guidelines for Cardiovascular Disease Prevention in a European Cohort. JAMA. 2014 Mar 29. doi: 10.1001/jama.2014.2632. PubMed ID: 24681960
7. Navar-Boggan AM, Newby LK. ACC/AHA Pooled Cohort Risk Equations predicted 5-y risk for CV events in adults considered for statin initiation. Ann Intern Med. 2014 Aug 19;161(4):JC12. PubMed ID: 25133379
8. Muntner P, Colantonio LD, Cushman M, et al. Validation of the Atherosclerotic Cardiovascular Disease Pooled Cohort Risk Equations. JAMA. 2014 Mar 29. doi: 10.1001/jama.2014.2630. PubMed ID: 24682252
9. DeFilippis AP, Young R, Carrubba CJ, et al. An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort. Ann Intern Med. 2015 Feb 17;162(4):266-75. PubMed ID: 25686167
10. Ridker PM, Cook NR. Comparing cardiovascular risk prediction scores. Ann Intern Med. 2015 Feb 17;162(4):313-4. PubMed ID: 25686171
11. Pursnani A, Massaro JM, D'Agostino RB Sr, et al. Guideline-Based Statin Eligibility, Coronary Artery Calcification, and Cardiovascular Events. JAMA. 2015 Jul 14;314(2):134-41. PubMed ID: 26172893
12. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016 Nov 15;316(19):1997-2007. PubMed ID: 27838723