Ascvd Risk Estimator App Download

The American Heart Association and the American College of Cardiology are excited to provide a series of cardiovascular prevention guidelines for the assessment of cardiovascular risk, lifestyle modifications that reduce risk, management of elevated blood cholesterol, and management of increased body weight in adults.

The information required to estimate ASCVD risk includes age, sex, race, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure lowering medication use, diabetes status, and smoking status.

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The ACC/AHA 2018 Cholesterol Guidelines and 2017 Hypertension Guidelines recommend the use of quantitative 10-year risk assessment, based on measurement of traditional ASCVD risk factors and with use of a validated risk prediction tool, as the first step in considering treatment options for primary prevention. Results of 10-year risk estimation should be communicated through a clinician-patient risk discussion to decide upon the intensity of preventive measures, especially whether to initiate medical therapy.

The estimates of lifetime risk are most directly applicable to non-Hispanic whites. We recommend the use of these values for other race/ethnic groups, though as mentioned above, these estimates may represent under- and overestimates for persons of various ethnic groups. Because the primary use of these lifetime risk estimates is to facilitate the very important discussion regarding risk reduction through lifestyle change, the imprecision introduced is small enough to justify proceeding with lifestyle change counseling informed by these results.

As shown above, among patients who do not otherwise have a compelling indication for statin therapy, the Pooled Cohort Equations can be used to estimate primary cardiovascular risk and potential benefit from statin therapy.

ASCVD stands for atherosclerotic cardiovascular disease, defined as a nonfatal myocardial infarction (heart attack), coronary heart disease death, or stroke. The purpose of the Pooled Cohort Equations is to estimate the risk of ASCVD within a 10-year period among patients who have never had one of these events in the past.

The Pooled Cohort Equations were developed and validated among Caucasian and African American men and women who did not have clinical ASCVD. There are inadequate data in other racial groups, such as Hispanics, Asians, and American-Indian populations. Given the lack of data, current guidelines suggest to use the "Caucasian" race to estimate 10-year ASCVD risk with the knowledge that further research is needed to stratify these patients' risk. Compared to Caucasians, the risk of ASCVD is generally lower among Hispanic and Asian populations and generally higher among American-Indian populations.

The Pooled Cohort Risk Assessment Equations was developed by the Risk Assessment Work Group, an arm of the ACC/AHA Cardiovascular Risk Guidelines, to identify appropriate candidates for statin therapy based on elevated cardiovascular risk.1 Statistical modeling to create a new risk assessment tool was developed using a variety of participants from several large, diverse NHLBI-sponsored studies.

In individuals aged 20 to 59 years of age, a lifetime risk assessment is mentioned by guidelines (with a 'low' strength of evidence).1 A long-term risk assessment may be more accurate in younger individuals free from ASCVD (eg, 20 to 59 years old). This lifetime estimation was based on a paper published in 2006 that was developed by assigning a patient into one of five mutually exclusive sex-specific groups.4 In some cases, the 10-year ASCVD risk may be higher than lifetime risk due to differing mathematical approaches. If this is the case, the 10-year risk should be the primary focus for risk identification.

Cardiovascular risk prediction models encompass numerous CVD risk factors. Available prediction models were developed from non-Asian cohorts hence we decided to evaluate the performance of the ASCVD risk estimator model and the associated 10-year CVD predisposing factors in Punjab.

According to our prediction study, it was discovered that 145 (72.1%) participants were not likely to have had an ASCVD in the next 10 years. However, middle-aged males should be more cautious with their lifestyle habits, particularly in dealing with risk factors that can expose them to CVDs.

According to the World Health Organization (WHO), about 17.9 million deaths reported globally in 2019 resulted from cardiovascular diseases. These accounted for 32% of the total deaths making them the leading cause of deaths globally. Stroke and heart failure accounted for 85% of these deaths. Notably, these conditions can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, and harmful use of alcohol [1]. According to a study that evaluated the changing patterns in India from 1990 to 2016, it was discovered that CVD diseases contributed to 28.1% of the total deaths. These deaths also increased from 1.3 million in 1990 to 2.8 million in 2016 with Kerala and Punjab having the leading prevalence rates [2].

The current epidemiological evidence suggests an elevated percentage of CVD diseases among Indians. This is a source of concern considering the incidence rate of these diseases is higher in the younger age. About 291 million people had CVDs in 1990 however this number has extremely skyrocketed to 523 million in 2019. Alternatively, the number of CVD deaths rose from 12.1 million in 1990 to 18.6 million in 2019 globally [3]. The catastrophic effects of CVDs continue to be experienced globally and particularly in low-income countries where lifestyle, and poor healthcare among other factors are prevalent. A cardiovascular risk calculator is a screening tool that is used in cardiovascular risk assessment. These tools mainly predict the risk of an individual developing a heart condition in the future (i.e., 5 years, 10 years, or lifetime. The concept of cardiovascular risk assessment was introduced by the Framingham heart study in 1948 in the USA. It was the first cardiovascular observational longitudinal cohort study established to identify the epidemiology and risk factors for cardiovascular diseases.

The early death of USA President Franklin Delano Roosevelt in 1945 led to the development of the National Heart Institute currently named the National Heart, Lung, and Blood Institute in 1948. This study was meant to be a 20-year study however by 1968, the study had yet to accomplish its objectives and hence it was extended through funds from donors along with a supplementary grant from President Richard Nixon. Kannel, Truett, and Cornfield published the first multivariable risk function for atherosclerotic heart disease in 1967. In 1976, Kannel and colleagues established the first risk profile having a general cardiovascular occurrence as the endpoint. In 1998, the Framingham Risk Score for coronary heart disease was developed by Wilson and colleagues and it was the best risk profile until that time. Subsequently, it became the base risk profile for the development of other cardiovascular risk profiles [4].

According to WHO, cardiovascular diseases are the leading cause of death worldwide (17.9 million) as well as in India (272 per 100,000 persons) [5]. Indians are at a higher risk of developing cardiovascular diseases than their Western counterparts and it has been reported by WHO that one-fifth of the global CVD deaths arise from India. Some of the major concerns of CVD condition in Indians are the early age onset, the rapid deterioration, and increasing mortality rates [6]. It is important to detect cardiovascular disease as early as possible so that management with counseling and medication can begin. Cardiovascular risk prediction models play a crucial role in the prevention and management of the CVDs. Various CVD prediction models have been developed worldwide with the Framingham risk score model being the most commonly used [7,8,9].

Cardiovascular risk prediction models are important in early CVD detection, patient counseling, specific disease surveillance, identifying risks and regional differences, and developing health promotion programs [10]

In our study, the ASCVD Risk Estimator Plus risk prediction model was used to predict 10-year cardiovascular outcomes. The ASCVD Risk Estimator Plus model was developed to minimize the ASCVD overprediction in certain groups of individuals noted in the PCE model. Although it has been noted to overpredict ASCVD outcomes in Asians, it still has been shown to have significant clinical usefulness. Rifai et al. [11] aimed to compare the ASCVD score and coronary artery calcium (CAC) of various races. According to the study, South Asians at low and intermediate levels of ASCVD score were likely to have a zero CAC score. Logistic regression models were used to were used to assess the relationship between ethnicity and ASCVD score. The authors concluded that ASCVCD is likely to overestimate the South Asians who have been categorized as either low or intermediate risk however it can be used for clinical decision making [11].

Participants who were only drug abusers were about 2 times associated with a greater probability of developing CVD compared to those who were sober/ did not abuse drugs. Some of the drugs being abused were charas and bhang and it is known that the consumption of cannabis products imposes a risk of tachycardia.

Respondents who combined smoking and alcoholism were 5 times associated with a higher likelihood of developing CVD compared to those who were sober. Participants who combined alcoholism and drug abuse were about 4 times linked with a higher probability of developing CVD compared to those who were sober. Respondents who are alcoholics, smokers, and drug abusers are about 6 times more likely to develop CVD as compared to their sober counterparts as seen in Table 3 below. Gender was discovered to be one of the factors of 10- a year risk of CVDs. Participants who were males were about 4 times associated with a higher likelihood of developing CVD compared to females. It is known that males are at a higher susceptibility to developing CVD in comparison to females. ff782bc1db