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Calculator: Cardiovascular risk assessment in adults (10-year, ACC/AHA 2013) (conventional and SI units)


 Calculator: Cardiovascular risk assessment in adults (10-year, ACC/AHA 2013) (conventional and SI units)

 
Input
 
Race African American

 White

 Other (see notes)
Sex Female

 Male
Age  
Total cholesterol  
HDL cholesterol  
Systolic blood pressure  
On hypertension medication No

 Yes
Diabetes No

 Yes
Smoking No

 Yes

 
Results
 
Important: Inputs must be complete to perform calculation.

 
 
10-year risk  
 
Decimal precision  

 
 

 

 
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[3] 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 Native Americans, Asian Americans of South Asian ancestry, and Puerto Ricans. Risk may be overestimated in Asian Americans of East Asian ancestry and some Mexican Americans.
  • This calculator has only been validated for ages 40 to 79 years.
  • ACC: American College of Cardiology; AHA: American Heart Association; HDL: high-density lipoprotein; ASCVD: atherosclerotic cardiovascular disease; CHD: coronary heart disease.

 
Equations used
 
Terms = (C_Age * ln(Age)) + (C_Sq_Age * sq(ln(Age))) + (C_Total_Chol * ln(Total_cholesterol)) + (C_Age_Total_Chol * ln(Age) * ln(Total_cholesterol)) + (C_HDL_Chol * ln(HDL_cholesterol)) + (C_Age_HDL_Chol * ln(Age) * ln(HDL_cholesterol)) + (On hypertension medication * C_On hypertension medications * ln(Systolic blood pressure)) + (On hypertension medication * C_Age_On hypertension medications * ln(Age) * ln(Systolic blood pressure)) + (not On hypertension medication * C_Off_Hypertension_Meds * ln(Systolic blood pressure)) + (not On hypertension medication * C_Age_Off_Hypertension_Meds * ln(Age) * ln(Systolic blood pressure)) + (C_Smoking * Smoking) + (C_Age_Smoking * ln(Age) * Smoking) + (C_Diabetes * Diabetes)
10-year risk = 100 * (1 - S10e(Terms-Mean_Terms))

 

 
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; CSmoking = 0.691; CAgeSmoking = 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; CSmoking = 7.574; CAgeSmoking = -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; CSmoking = 0.549; CAgeSmoking = 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; CSmoking = 7.837; CAgeSmoking = -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 2014; 129:S49.
  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 2014; 129:S1.
  3. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet 2013; 382:1762.
  4. Downs J, Good C. New Cholesterol Guidelines: Has Godot Finally Arrived? Ann Intern Med 2014; 160:354.
  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; 161:JC13.
  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; 311:1416.
  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; 161:JC12.
  8. Muntner P, Colantonio LD, Cushman M, et al. Validation of the Atherosclerotic Cardiovascular Disease Pooled Cohort Risk Equations. JAMA 2014; 311:1406.
  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; 162:266.
  10. Ridker PM, Cook NR. Comparing cardiovascular risk prediction scores. Ann Intern Med 2015; 162:313.
  11. Pursnani A, Massaro JM, D'Agostino RB Sr, et al. Guideline-Based Statin Eligibility, Coronary Artery Calcification, and Cardiovascular Events. JAMA 2015; 314:134.
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