By J. Douglas Overbeck, M.D.
The American College of Cardiology (ACC) and the American Heart Association (AHA) have coordinated with the National Heart, Lung, and Blood Institute and other societies to issue four guidelines on evaluating cardiovascular risk, lifestyle changes to decrease that risk, and the management of increased blood cholesterol and body weight in adults. Along with the guidelines, the ACC and AHA have created a new mobile cardiovascular risk calculator application intended as a companion to the CV risk guidelines.
The ASCVD (Atherosclerotic Cardiovascular Disease) Risk Estimator application utilizes the Pooled Cohort Equations and lifetime risk prediction tools in order to assist health care providers and patients when calculating comprehensible estimates for ten-year and lifetime development of ASCVD. The estimator requires information on specific variables such as age, sex, race, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure medication use, diabetes, and smoking status to estimate ASCVD risk. The application also features guideline references on therapy, risk monitoring, and lifestyle recommendations, including a heart-healthy diet, regular aerobic exercises, maintaining a healthy weight and refraining from use of tobacco products.
While the Framingham ten-year risk score has been a standard in the United States, the ACC and AHA Work Group decided not to include the Framingham equation because it originated from an exclusively White sample group and was limited to coronary heart disease events. The ASCVD Risk Estimator includes in its assessment stroke and heart attack, and it provides sex and race specific ten-year risk estimates for African American and White men and women from 40 to 79 years of age.
Like most estimators and guidelines, the results and recommendations from the ASCVD Risk Estimator application do not replace a professional clinical assessment. The estimator is to be used as a guide, and individual needs should be evaluated and determined after speaking with a health care provider.