Cardiovascular disease risk assessment in adults without a history of atherosclerotic cardiovascular disease*^¶

CVD: cardiovascular disease; LDL: low-density lipoprotein; apoB: apolipoprotein B; CRP: C-reactive protein; ABI: ankle-brachial index; DM: diabetes mellitus.
* Patients with known CVD should receive appropriate treatment for secondary prevention; refer to UpToDate topics on secondary prevention of CVD.
¶ Patients >75 years of age may wish to undergo CVD risk assessment following a discussion of the risks and benefits of treatment and shared decision making.
Δ Refer to UpToDate topics on familial hyperlipidemia and secondary prevention of CVD.
◊ Validated risk calculators have not included patients <40 years of age. If desired, a more formal risk estimate can be calculated using an imputed age of 40 years in this population.
§ Refer to UpToDate table on risk-enhancing factors for clinician-patient risk discussion.
¥ Patients under 40 years of age with either type 1 or type 2 DM are at very high risk of CVD events, and their risk should be managed aggressively.
‡ Refer to UpToDate content on CVD risk assessment in primary prevention for available risk calculators to estimate 10-year and lifetime CVD risks.
† Patients may reasonably consider stopping cholesterol screening beyond age 65 years if they have had multiple prior normal lipid profiles. Refer to UpToDate content on screening for lipid disorders in adults for additional information.