What is a cardiovascular risk assessment?
This is a group of tests and health factors that have been scientifically proven to indicate a person’s chance of having a cardiovascular event such as a heart attack or stroke.
Why you need cardiovascular risk calculation?
It helps you to prevent, predict, and monitor cardiovascular diseases (plaque buildup disease). There are 4 main types based on where the plaque buildup occurs:
Coronary heart disease: Heart attack, angina, and/or heart failure
Cerebrovascular disease: Brain attack (stroke), transient ischemic attack (TIA)
Peripheral artery disease: High blood pressure, intermittent claudication (leg pains), Erectile dysfunction, etc.
Aortic atherosclerosis: Thoracic or abdominal aortic aneurysm (AAA)
What factors included in cardiovascular risk calculation?
Age, gender, race (ethnicity), family history
Controllable risk factors:
Cholesterol (total and HDL), blood pressure (medication used to control blood pressure), body weight (BMI), diabetes, calcium score (heart scan), CRP (inflammation marker), smoking, diet, exercise
- Family history of early ASCVD (men <55 years old, women <65)
- High-risk ethnicity (e.g. South Asian Indian Ancestry)
- Good and Bad Cholesterol particle number (LDL-P, HDL-P)
- Triglycerides ≥175 mg/dL
- Elevated lipoprotein (a) ≥50 mg/dL)
- Elevated apolipoprotein B ≥130 mg/dL
- Metabolic syndrome
- Chronic kidney disease
- Chronic inflammatory conditions (e.g., rheumatoid arthritis, psoriasis, HIV)
- History of pre-eclampsia or early menopause
- High-sensitivity C-reactive protein (HSCRP) ≥2.0mg/dL
- Ankle-brachial index (ABI) ‹0.9
- Sleep apnea
Impact of Race on Cardio-vascular risk
The Pooled Cohort Equations were developed and validated among Caucasian and African Americans.
Indian diaspora (people of India origin) constitute 25% of the world population but account for 60% of cardiovascular disease in the world.
MESA Risk Calculator (Caucasian, Chinese, African American, Hispanic) BUT no category for Asian Indians
Multiethnic risk calculator is available online. It includes Coronary calcium score data input as well. However, it does not include Asian Indians.
How far do you predict cardiovascular risk?
There are two ranges: 10-year prediction, Lifetime prediction.
What are two Risk Calculation Tools
- Heart age tool
- Cardiovascular risk prediction tools
The Heart Age Tool
- Is your heart older or younger than your real age?
- Heart Age Test calculates how many years you can expect to live without a heart attack or stroke.
- This tool is a collaboration between NHS Choices, Public Health England, and the British Heart Foundation. It is FREE and you can take the heart age test at this site.
The current US guidelines for cholesterol and blood pressure management call for use of the “pooled cohort” risk equations to help guide therapy. It is developed by Risk Assessment Work Group, an arm of the ACC/AHA. You can use the links below to calculate your own risk using major
North American (US and Canadian Data Base)
You can choose between 4 different databases by clicking on a specific calculator.
- Framingham – this calculates the risk of heart attacks + angina/coronary insufficiency + heart failure + strokes + intermittent claudication
- QRISK®2-2014 – this calculates the risk of heart attacks + strokes
- ACC/AHA ASCVD – this calculates the risk of CHD death + nonfatal heart attacks + fatal/nonfatal strokes
- PREDICT – Heart attacks + angina + heart failure + strokes/TIAs + peripheral vascular disease
Astro-CHARM (the “App”) incorporating traditional cardiovascular risk factors and coronary artery calcium score values.
Reynolds risk score
This calculator also uses a high-sensitivity CRP level, which is a marker of inflammation
The U-prevent calculators
Our preferred risk calculation tool because it includes all races and ethnic groups, all ages, and also calculates treatment effects.
- This tool helps to calculate 5- or 10-year cardiovascular risk as well as lifetime treatment effect.
- This online tool incorporates the inputs of scientists and regulatory agencies from North America (USA and Canada) and Europe.
- U-Prevent offers calculators for the following adult patient groups: 1) apparently healthy people, 2) vascular patients, 3) type 2 diabetes patients, and 4) elderly.
- This tool is much easier to use compared to looking at the guideline hubs of American College of Cardiology/American Heart Association 10-year cardiovascular risk prediction.
- To repeat, this tool estimates risk and benefit for primary prevention as well as secondary prevention. It also helps to decide the risk/benefit for the elderly.