About the ASCVD Risk Calculator
The ASCVD risk calculator is an estimator of the risk of individuals who could potentially develop complications of atherosclerotic cardiovascular disease over a 10 year period. Atherosclerotic cardiovascular diseases are defined by the American College of Cardiology as death due to fatal / nonfatal myocardial infarction and fatal / nonfatal stroke.
The ASCVD risk calculator is gradually replacing the Framingham risk score. The information required to compute the ASCVD risk calculator includes age (the calculator is most accurate between 40-75 years), gender, race, total cholesterol, HDL cholesterol, systolic blood pressure, use of blood pressure lowering medications, diabetes status, and current smoking status.
The ASCVD risk calculator was developed, and, has been validated in caucasian and african american men and women who did not have clinical atherosclerotic cardiovascular disease. Initial studies found that the risk of atherosclerotic cardiovascular disease is generally lower among hispanic and asian americans and is higher in American Indian populations compared to caucasian populations. The main intention of the calculator was to estimate who would benefit from prophylactic statin therapy.
The ASCVD risk score is expressed as a percentage. This is the percentage chance of having heart disease or stroke in the following 10 years. Prophylactic and treatment recommendations would depend on the estimated risk score.
0 to 4.9% risk is considered low. Eating a healthy diet and exercising will should suffice. Medication is not necessary unless the LDL, or “bad” cholesterol, is greater than 190.
5 to 7.4% risk is considered borderline. Use of a statin medication may be necessary if you have other conditions, which may be “risk enhancers.” These include:
- Family history of early-onset ASCVD
- Continually elevated LDL greater than or equal to 160 mg /dL with a low HDL level.
- Chronic kidney disease
- Metabolic syndrome
- Preeclampsia or premature menopause
- Inflammatory diseases such as rheumatoid arthritis, psoriasis, or HIV
- South Asian ancestry
- Continually elevated triglycerides greater than or equal to 175 mg /dL
7.5 to 20% risk is considered intermediate. It is recommended that moderate intensity statin therapy be initiated immediately.
A greater than 20% risk is considered high. It is recommended that you start with high intensity statin therapy immediately.