Age (years) | |
Gender | Male Female |
Race | White African American |
Total Cholesterol (mg/dL) | |
HDL (mg/dL) | |
Systolic BP (mmHg) | |
Is reported SBP treated or untreated | Treated Untreated |
Current smoker | Yes No |
Diabetic | Yes No |
Inputs:
Score (start with 0):
First, categorize patient by gender and race: WM, WF, AM, AF (White, African-American, Male, Female)
Second, using the following table, choose the correct coefficient for each factor, based on gender/race:
White male | AA male | White female | AA female | |
A = ln(age) * | 12.344 | 2.469 | -29.799 | 17.114 |
B = [ln(age)]2 * | 0 | 0 | 4.884 | 0 |
C = ln (total chol) * | 11.853 | 0.302 | 13.540 | 0.940 |
D = ln(age) * ln(total chol) * | -2.664 | 0 | 3.114 | 0 |
E = ln(hdl) | -7.990 | -0.307 | -13.578 | -18.920 |
F = ln(age) * ln(hdl) * | 1.769 | 0 | 3.149 | 4.475 |
** NOTE: USE EITHER TREATED OR UNTREATED, NOT BOTH FOR G THROUGH J | ||||
G = ln(treated SBP) * | 1.797 | 1.916 | 2.019 | 29.291 |
H = ln(age) * ln(treated SBP) * | 0 | 0 | 0 | -6.432 |
I = ln(untreated SBP) * | 1.764 | 1.809 | 1.957 | 27.820 |
J = ln(age) * ln(untreated SBP) * | 0 | 0 | 0 | -6.087 |
**NOTE: IF NON-SMOKER, K & L are both 0. | ||||
K = If smoker, 1 * | 7.837 | 0.549 | 7.574 | 0.691 |
L = If smoker, ln(age) * | -1.795 | 0 | -1.665 | 0 |
** NOTE: IF NON-DIABETIC, M is 0 | ||||
M = If diabetic, 1 * | 0.658 | 0.645 | 0.661 | 0.874 |
S = Sum of A through M | ||||
T = Age/Gender based Mean: | 61.18 | 19.54 | -29.18 | 86.16 |
U = A/G based Survival: | 0.9144 | 0.8954 | 0.9665 | 0.9533 |
X = e ^ (S - T)
Score = 100 * (1 - U ^ X)
Report:
Estimated 10 year risk of a first hard atherosclerotic cardiovascular disease (ASCVD) event, defined as MI, cardiovascular death, or CVA, in a patient without known ASCVD, is Score %.
If Score >= 7.5, add: "This risk is higher than 7.5%; in this elevated risk group, statin use has been demonstrated to reduce mortality."
If Score <7.5, add: "This risk is less than 7.5; in this low risk group, statin use has not been demonstrated to improve mortality."
If age is <40 or >79, add: "Results are only valid for patients between the ages of 40 and 79. Clinical utility for using this calculator outside of this age range is limited."
Notes: This calculator was released in November 2013, and is based only on data from the highest-quality studies, which discounted large amounts of data that had driven clinical practice for many years. This resulted in a great deal of controversy, and suspicion that it would lead to over-use of statins.
Reference: 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, published online at http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437741.48606.98.full.pdf+html