Clinicians and patients should weigh and incorporate the information provided by this app in the context of other considerations, including recommended lifestyle interventions, patient preferences for taking medications, potential adverse drug reactions or interactions, and which treatment intervention approach might be most successful for a particular patient.
Therapy Impact tab: Form a risk-lowering intervention plan with your patient at an initial visit. However, the app now includes additional capabilities to estimate and track change in risk over time, and forecast potential benefit of specific risk-lowering interventions. The ASCVD Risk Estimator Plus has also expanded the guidance provided by including expert advice regarding blood pressure-lowering therapy, aspirin use, and smoking cessation, along with the original statin initiation recommendations.
The App was designed and vetted through collaboration with the authors of the source documents listed above, as well as other ACC clinical members. It was further refined via user testing with physicians, nurse practitioners, and pharmacists. This version of the application has been locked because of need to ugrade the science. Please go to the store upgrade this application.
Table 5. This calculator only provides year risk estimates for individuals years of age. Click here to view brief suggestions for younger patients. Reset All. Forecast the potential impact of different interventions on patient risk. Follow up risk incorporates change in risk factor levels over time and requires both initial and follow up values. Use the information above to help with clinician-patient discussions on risk and risk-lowering interventions.
Current Age. Because the primary use of these 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. Systolic Blood Pressure mm Hg. Diastolic Blood Pressure mm Hg. Value must be between - Value must be between 3.
Value must be between 20 - Value must be between 0. History of Diabetes? Current Former Never. How long ago did patient quit smoking? On Hypertension Treatment? On a Statin? On Aspirin Therapy?
Do you want to refine current risk estimation using data from a previous visit? Values at Previous Visit. Reset Reset. Age at Previous Visit. Age is Missing. Total Cholesterol is Missing. Systolic Blood Pressure is Missing. On Hypertension Treatment at Previous Visit? Treatment Hypertension is Missing.
History of Diabetes at Previous Visit? Was a Smoker at Previous Visit or within a year before the visit? Determine Therapy Impact Potential risk reduction impact of different therapies can only be calculated for patients years of age at an initial visit.
View Advice Advice section is accessible when required characteristics for patients years of age are entered. Project Risk Reduction by Therapy. Remove this scenario. Risk is not shown for therapy s that are not recommended. View All Risk Reduction Scenarios. Estimate Risk. Email Advice. Blood Pressure Management for this Patient.
Tobacco Cessation for this Patient. Diabetes Mellitus Management General. For adults with type 2 diabetes mellitus: - A tailored nutrition plan focusing on a heart-healthy dietary pattern is recommended to improve glycemic control, achieve weight loss if needed , and improve other ASCVD risk factors I, A.
This includes adults with type 2 diabetes mellitus I, A. For adults unable to meet the minimum physical activity recommendations: - Engaging in some moderate or vigorous intensity physical activity, even if less than this recommended amount, can be beneficial to reduce ASCVD risk IIa, B-NR. Aspirin Use Recommendations for this Patient.
Statins: There is moderate quality evidence that statins do not increase the overall risk of adverse events, but that they may increase the risk of diagnosis of type 2 diabetes in certain individuals. Blood Pressure-Lowering Therapies: Adverse effects of blood-pressure-lowering therapies are generally poorly reported, and vary by drug class. Tobacco Cessation: Adverse effects of tobacco cessation therapies are generally poorly reported, and vary by drug.
Aspirin: There is high-quality evidence indicating that aspirin may increase the risk of major bleeding. A calculator for considering major bleeding risks and potential benefits of aspirin therapy for MI and stroke prevention is available here. Actual Risk Projected Risk. J Am Coll Cardiol ;e— J Am Coll Cardiol.
J Am Coll Cardiol ;— Circulation — Clinician Resources. Patient Resources. In Press. Here are the highlights of the guideline: Risk assessments are used to determine the likelihood of a patient developing cardiovascular disease, heart attack or stroke in the future. Diet Diet is a vital tool for lowering cholesterol and blood pressure levels, which are two major risk factors for cardiovascular disease. Patients with high cholesterol and high blood pressure levels should eat plenty of vegetables, fruits and whole grains and incorporate low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils and nuts into their diet.
They should also limit intake of sweets, sugar-sweetened beverages and red meats. Patients who need to lower their cholesterol should reduce saturated and trans fat intake. Patients with high blood pressure should consume no more than 2, mg of sodium a day, ideally reducing sodium intake to 1, mg a day.
However, even reducing sodium intake in one's current diet by 1, mg each day can help lower blood pressure. It's important to adapt the recommendations above, keeping in mind calorie requirements, as well as, personal and cultural food preferences. Nutrition therapy for other conditions like diabetes should also be considered.
Doing so helps create healthy eating patterns that are realistic and sustainable. Physical Activity Regular physical activity helps lower cholesterol and blood pressure, reducing the risk for cardiovascular disease.
In general, adults should engage in aerobic physical activity times a week with each session lasting an average of 40 minutes. Moderate brisk walking or jogging to vigorous running or biking physical activity is recommended to reduce cholesterol levels.
Here is what every patient should know about the treatment of overweight and obesity: Definition of obesity: Obesity is a medical condition in which excess body fat has accumulated to the extent that it can have an adverse effect on one's health. Key Points Based on the most up-to-date and complete look at available clinical trial results: Health care providers should focus on identifying those people who are most likely to have a heart attack or stroke and make sure they are given effective treatment to reduce their risk.
These tests may include: Lifetime risk estimates —how likely you are to have a heart attack and stroke during your lifetime Coronary artery calcium CAC score —a test that shows the presence of plaque or fatty build-up in the heart artery walls High-sensitivity C-Reactive Protein CRP —a blood test that measures the amount of CRP, a marker of inflammation or irritation in the body; higher levels have been associated with heart attack and stroke Ankle-brachial index ABI —the ratio of the blood pressure in the ankle compared to blood pressure in the arm, which can predict peripheral artery disease PAD If you have very high levels of low-density lipoprotein LDL or "bad" cholesterol, your care provider may want to find out if you have a genetic or familial form of hypercholesterolemia.
Your Treatment Plan Before coming up with a specific treatment plan, your care provider will talk with you about options for lowering your blood cholesterol and reducing your personal risk of atherosclerotic disease. Heart-Healthy Lifestyle Adopting a heart-healthy lifestyle continues to be the first and best way to lower your risk of problems.
Experts suggest: Eating a diet rich in vegetables, fruits, and whole grains ; this also includes low-fat dairy products, poultry, fish, legumes, and nuts; it limits intake of sweets, sugar-sweetened beverages and red meats. Maintaining a healthy weight. Not smoking or getting help quitting. Medications There are two types of cholesterol-lowering medications: statins and non-statins. Statin Therapy There is a large body of evidence that shows the use of a statin provides the greatest benefit and fewest safety issues.
Sometimes more than one statin needs to be tried before finding the one that works best. Other cholesterol-lowering medications Not all patients will be able to take the optimum dose of statin. It can be used to make more precise decisions about treatment to prevent heart attack and stroke. This newer LDL cholesterol formula is being adopted by U. The best implementation is direct coding the LDL cholesterol estimation in the lab IT system, which automates the process and saves clinicians time.
Researchers hope the new formula will one day be adopted by all labs that process lipid panels, as it can improve patient care. Arteries are-te-rease : The blood vessels that carry oxygen-rich blood away from your heart for delivery to every part of your body. Arteries look like thin tubes or hoses. The walls are made of a tough outer layer, a middle layer of muscle and a smooth inner wall that helps blood flow easily. The muscle layer expands and contracts to help blood move.
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