This calculator should be used for primary prevention patients (those without ASCVD) only.
How to use the calculator:
This calculator is based on ASCVD Pooled Cohort Risk Equations (Goff 2013) as of the following:
This calculator helps predict the 10-year risk of the following hard ASCVD events:
This calculator may overestimate risk 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.
Always engage in a clinician-patient discussion of the potential for ASCVD risk reduction, adverse effects, drug-drug interactions, and patient preferences. Consider:
Statin therapy is not routinely recommended for individuals with New York Heart Association class II to IV heart failure or who are receiving maintenance hemodialysis.
The guidelines recommend the treating clinician consider:
The guidelines recommend the treating clinician consider patients with:
|Risk Score||Severity||Risk Discussion|
|<5%||Low Risk||Emphasize lifestyle to reduce risk factors|
|5-<7.5%||Borderline Risk||If risk enhancers present, then risk discussion regarding moderate-intensity statin therapy|
|≥7.5-<20%||Intermediate Risk||If risk estimate + risk enhancers favor statin, initiate moderate-intensity statin to reduce LDL-C by 30 to 49%|
If risk decision is uncertain, Consider measuring Coronary Artery Calcium (CAC) in selected adults: CAC = zoro (lowers risk; consider no statin, unless diabetes, family history of premature CHD, or cigarette smoking are present); CAC = 1-99 favors statin (especially after age 55); CAC = 100+ and/or ≥75th percentile, initiate statin therapy.
|≥20%||High Risk||Initiate statin to reduce LDL-C ≥50%|
ASCVD Risk Enhancers:
In selected individuals if measured:
|Risk Score||Target Blood Pressure||Comment|
|<10%||140/90 mmHg||Use of blood pressure-lowering medication is recommended for primary prevention of CVD in adults with no history of CVD and with an estimated 10-year ASCVD risk <10% and blood pressure ≥140/90 mmHg.|
|≥10%||130/80 mmHg||Use of blood pressure-lowering medications is recommended for primary prevention in adults with an estimated 10-year ASCVD risk of ≥10% and blood pressure ≥130/80 mmHg.|
|Intensity||LDL Lowering||Medication (mg/day)|
|High||≥50%||Atorvastatin 40–80; Rosuvastatin 20-40|
|Moderate||30% to <50%||Atorvastatin 10-20; Rosuvastatin 5-10; Simvastatin 20–40; Pravastatin 40-80; Lovastatin 40; Fluvastatin 80 (IR BID dosing); Pitavastatin 2–4|
|Low||<30%||Simvastatin 10; Pravastatin 10–20; Lovastatin 20; Fluvastatin 20–40; Pitavastatin 1|
Total Cholesterol mg/dL
HDL Cholesterol mg/dL
Systolic blood pressure mmHg
Treated for high blood pressure