ASCVD Risk Calculator
What Is ASCVD?
ASCVD or atherosclerotic (ah-thr-oh-sklr-aw-tick) cardiovascular disease is heart disease that also affects your blood vessels. Atherosclerosis is a type of heart disease in which excessive fats in your blood begin to stick to your blood vessels and form dangerous plaques. As this builds up, the space in which blood flows becomes narrowed, increasing the pressure and making it more difficult for blood to flow. More dangerously, sometimes these plaques can break off and end up in another blood vessel, ultimately blocking off blood flow completely to that part of the body. This could potentially cause a dangerous event such as a heart attack or stroke.
What is the ASCVD Risk Calculator?
The ASCVD risk calculator is a tool used by healthcare professionals to determine your personal risk of developing ASCVD. This is calculated as a percent risk within the next 10 years as well as within a lifetime. It is only used for individuals between the ages of 40-79 without pre-existing heart disease. If you have a history of heart attack or stroke, this particular calculator is no longer useful in the same way. The idea of this calculation is to assess which intervention(s) would be appropriate for your individual risk score in order to minimize the possibility of your development of ASCVD.
Factors Involved in the Calculation
There are many factors involved in the risk calculation. It considers factors about both your past and present medical history. You will most likely be required to get blood testing done before your risk can be calculated, unless you have had the required blood work done recent enough.
The full ASCVD risk calculation is divided into three categories:
Patient lab values:
- Systolic and diastolic blood pressure
- Total cholesterol
- HDL-cholesterol (“good” cholesterol)
- LDL-cholesterol (“bad” cholesterol)
- History of diabetes
- Current or past smoking history
- Treatment for high blood pressure
- On cholesterol medication (statins)
- History of taking aspirin for heart-related issues
Each factor represents its own individual risk, and put together, is able to calculate the percent risk you have of developing ASCVD within the next 10 years and throughout your lifetime.
What Does My Score Mean?
Your score will be graded into one of four groups:
- Low risk (<5%)
- Borderline risk (5-7.5%)
- Intermediate risk (7.5-20%)
- High risk (>20%)LDL-cholesterol (“bad” cholesterol)
So, what does this mean?
While informative and helpful for a healthcare professional to guide treatment, the score itself is not perfect. Having a low score does not mean you will never have a heart-related event such as a heart attack and having a high score does not necessarily mean you absolutely will have a heart-related event.
However, this score is important in order to inform your healthcare provider about how aggressive they need to be with your management. Those with lower risk scores are generally recommended to make lifestyle changes in order to lower their risk/maintain their low risk. Those with higher risk scores are recommended more intensive risk reduction therapies. Additionally, they may be prescribed moderate- or high-intensity statin medications. These medications have been shown to decrease the risk of developing ASCVD-related morbidity and mortality in patients at higher risk. Those in lower risk categories do not show the same benefits from statin use.
This score can also be re-calculated over time in order to determine if your risk of ASCVD is increasing or decreasing and if this results in a change to your health management.
How Can I Decrease My Score?
This depends! In general, the first step is to modify the factors contributing to your risk. This involves smoking cessation, as well as controlling your blood pressure, diabetes, and/or cholesterol levels, depending on which factors are contributing to your individual risk.
It is important to listen to your healthcare provider’s advice based on your risk score. If there are barriers to managing your risk, such as difficulty remembering to take medication or inability lack of affordability, it is also very important to speak with your healthcare provider to discuss these risks. While some factors are not modifiable, such as age, sex, and age, others are able to be targeted for risk reduction.
Important changes for anyone to make include lifestyle modification. This may include:
- Eating a healthy diet, high in fruits, vegetables, and whole grains
- Maintain regular exercise (ideally 150 minutes of aerobic exercise per week)
- Maintain a healthy weight
- Limit consumption of alcohol
These modifications are essential in order to directly manage your risk of ASCVD, as well as improve specific risk factors such as blood pressure and cholesterol levels.
Both medications have similar mechanisms of action and can help improve blood sugar control in those with type 2 diabetes, and have similar side effects, including the following:
Getting Involved in Your Care
Many healthcare providers will calculate your risk score at a general health appointment once you reach a certain age. However, you can also take this into your own hands, and ask your provider to complete an assessment if they haven’t already. In addition, there are also some online calculators that you can do yourself to get a beginning idea of your own risk. However, in most cases it is still important to speak with a healthcare provider about this risk in order to best understand and manage your possibility of developing ASCVD.
- ASCVD risk estimator intended for patients with LDL-C. ASCVD Risk Estimator. (n.d.). Retrieved May 1, 2023, from https://tools.acc.org
- New aspects of the risk assessment guidelines: Practical highlights, scientific evidence and future goals. American College of Cardiology. (n.d.). Retrieved May 1, 2023, from https://www.acc.org
- Cardiac risk calculator and assessment. Cleveland Clinic. (n.d.). Retrieved May 1, 2023, from https://my.clevelandclinic.org