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When was this app last updated?
February 2024
How can I provide feedback?
Click here to fill out our feedback survey
How is this app intended to be used?
This Risk Estimator is intended as a companion tool to the2013 ACC/AHA Guideline on the Assessment of Cardiovascular Riskand the2018 AHA/ACC Guideline on the Management of Blood Cholesterol. This Risk Estimator enables health care providers and patients to estimate 10-year and lifetime risks for atherosclerotic cardiovascular disease (ASCVD), defined as coronary death or nonfatal myocardial infarction, or fatal or nonfatal stroke, based onthe Pooled Cohort Equations and lifetime risk prediction tools.
The Risk Estimator is intended for use in those without ASCVD with a LDL-cholesterol <190 mg/dL.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.
The results and recommendations provided by this application are intended to inform but do not replace clinical judgment. Therapeutic options should be individualized and determined after discussion between the patient and their care provider.
How are the estimates in this app calculated?
10-Year ASCVD Risk Estimates
Estimates of 10-year risk for ASCVD are based on data from multiple community-based populations and are applicable to African-American and non-Hispanic white men and women 40 through 79 years of age.
For other ethnic groups, we recommend use of the equations for non-Hispanic whites, though these estimates may under- or overestimate risk for persons from some race/ethnic groups.
Lifetime ASCVD Risk Estimates
Estimates of lifetime risk for ASCVD are provided for adults 20 through 59 years of age and are shown as the lifetime risk for ASCVD for a 50-year old without ASCVD who has the risk factor values entered into the Estimator. 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 over-estimates 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.
10-Year Risk Estimates that Exceed Lifetime Risk Estimates
In rare cases, 10-year risks may exceed lifetime risks given that the estimates come from different approaches. The reported estimate of lifetime risk is based on assigning each person into one of 5 mutually exclusive sex-specific groups, as per Lloyd-Jones et al., Circulation 2006; 113(6):791-8. Within each of the 5 groups, each person receives the same lifetime risk estimate. In other words, using this approach, there are only 5 possible lifetime risk estimates reported for men and only 5 possible lifetime risk estimates reported for women. In some cases, the average risk for the group will underestimate the individual’s true lifetime risk. This feature of lifetime risk estimation will result in the estimated lifetime risk being less than the estimated 10-year risk. In these cases, the 10-year risk should be the primary focus for the risk discussion and risk reduction efforts.
2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk
David C. Goff, MD, PhD, FACP, FAHA • Donald M. Lloyd-Jones, MD, ScM, FACC, FAHA • Glen Bennett, MPH • Christopher J. O'Donnell, MD, MPH • Sean Coady, MS • Jennifer Robinson, MD, MPH, FAHA • Ralph B. D'Agostino,Sr, PhD, FAHA • J. Sanford Schwartz, MD • Raymond Gibbons, MD, FACC, FAHA • Susan T. Shero, MS, RN • Philip Greenland, MD, FACC, FAHA • Sidney C. Smith, MD, FACC, FAHA • Daniel T. Lackland, DrPH, FAHA • Paul Sorlie, PhD • Daniel Levy, MD • Neil J. Stone, MD, FACC, FAHA • Peter W.F. Wilson, MD, FAHA
2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
Neil J. Stone, MD, MACP, FAHA, FACC • Jennifer Robinson, MD, MPH, FAHA • Alice H. Lichtenstein, DSc, FAHA • C. Noel Bairey Merz, MD, FAHA, FACC • Donald M. Lloyd-Jones, MD, ScM, FACC, FAHA • Conrad B. Blum, MD, FAHA • Patrick McBride, MD, MPH, FAHA • Robert H. Eckel, MD, FAHA • J. Sanford Schwartz, MD • Anne C. Goldberg, MD, FACP, FAHA • Susan T. Shero, MS, RN • David Gordon, MD • Sidney C. Smith • Daniel Levy, MD • Karol Watson, MD, PhD, FACC, FAHA • Peter W.F. Wilson, MD, FAHA
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Michael D. Jensen, MD • Donna H. Ryan, MD • Caroline M. Apovian, MD, FACP • Catherine M. Loria, PhD, FAHA • Jamy D. Ard, MD • Barbara E. Millen, DrPH, RD • Anthony G. Comuzzie, PhD • Cathy A. Nonas, MS, RD • Karen A. Donato, SM • F. Xavier Pi-Sunyer, MD, MPH • Frank B. Hu, MD, PhD, FAHA • June Stevens, PhD • Van S. Hubbard, MD, PhD • Victor J. Stevens, PhD • John M. Jakicic, PhD • Thomas A. Wadden, PhD • Robert F. Kushner, MD • Bruce M. Wolfe, MD • Susan Z. Yanovski, MD
2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk
Robert H. Eckel, MD, FAHA • John M. Jakicic, PhD • Jamy D. Ard, MD • Nancy Houston • Miller, RN, BSN, FAHA • Van S. Hubbard, MD, PhD • Cathy A. Nonas, MS, RD • Janet M. de Jesus, MS, RD • Frank M. Sacks, MD, FAHA • I-Min Lee, MD, ScD • Sidney C. Smith • Alice H. Lichtenstein, DSc, FAHA • Laura P. Svetkey, MD, MHS • Catherine M. Loria, PhD, FAHA • Thomas W. Wadden, PhD • Barbara E. Millen, DrPH, RD, FADA • Susan Z. Yanovski, MD
2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol
Scott M. Grundy • Neil J. Stone • Alison L. Bailey • Craig Beam • Kim K. Birtcher • Roger S. Blumenthal • Lynne T. Braun • Sarah de Ferranti • Joseph Faiella-Tommasino • Daniel E. Forman • Ronald Goldberg • Paul A. Heidenreich • Mark A. Hlatky • Daniel W. Jones • Donald Lloyd-Jones • Nuria Lopez-Pajares • Chiadi E. Ndumele • Carl E. Orringer • Carmen A. Peralta • Joseph J. Saseen • Sidney C. Smith Jr • Laurence Sperling • Salim S. Virani • Joseph Yeboah
Application Development Credits
Concepts for this application adapted from the Cardiac Risk Assist App developed by Tin T.D. Nguyen, MD.
Special Thanks to the ACC Best Practice Quality Improvement Subcommittee, whose members have provided content development and review
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This Terms of Service and License Agreement constitutes a legal agreement (collectively, the "Agreement") between the American College of Cardiology Foundation ("ACCF") and You and your agents ("You") for the use of the LDL-C Lowering Therapy, Hypertriglyceridemia, Statin Intolerance, or ASCVD Risk Estimator tools in the Lipid Manager (“the Product”), whether You use the mobile application version of the Product or the web version of the Product. The Product allows You to access certain content included in the Product (“Content”).
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You assume all risks associated with use of the Product including, but not limited to any harm, injury or damages resulting directly or indirectly from the use of the Product, all such risks being known and understood by You. In consideration of your use of the Product, You, for yourself and anyone entitled to act on your behalf, waive and forever release ACCF, its officers, trustees, employees, representatives and successors from all claims and liabilities of any kind arising out of your use or misuse of the Product.
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THE PRODUCT AND CONTENT ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS. ACCF AND ITS SUPPLIERS EXPRESSLY DISCLAIM ALL WARRANTIES OF ANY KIND WITH RESPECT TO THE PRODUCT OR CONTENT, WHETHER EXPRESS OR IMPLIED, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON-INFRINGEMENT. ACCF MAKES NO WARRANTY THAT THE PRODUCT AND/OR ANY CONTENT THEREIN WILL MEET YOUR REQUIREMENTS, OR WILL BE UNINTERRUPTED, TIMELY, SECURE, CURRENT, ACCURATE, COMPLETE OR ERROR-FREE OR THE RESULTS THAT MAY BE OBTAINED BY USE OF THE PRODUCT OR ANY CONTENT THEREIN WILL BE ACCURATE OR RELIABLE. YOU UNDERSTAND AND ACKNOWLEDGE THAT YOUR SOLE AND EXCLUSIVE REMEDY WITH RESPECT TO ANY DEFECT IN OR DISSATISFACTION WITH THE PRODUCT IS TO CEASE ITS USE.
The Content on the Product is presented as an educational service intended for licensed healthcare professionals. While the Content in the Product is about specific medical and healthcare issues, the Content is not a substitute for or replacement of personalized medical advice and is not intended to be used as the sole basis for making individualized medical or health-related decisions.
The views and opinions expressed are those of the contributing authors and editors and do not necessarily represent the views of the ACCF. The material is not intended to present the only, or necessarily best, methods or procedures for the medical situations addressed, but rather is intended to represent an approach, view, statement or opinion.
Any reference to a specific therapy or commercial product in this Product does not constitute a guarantee or endorsem*nt by ACCF of the quality or value of such therapy or product or any claims made by the manufacturer of such therapy or commercial product.
In addition, any statements about such therapy or commercial products are solely based on published clinical prediction rules and estimates of drug treatment effects from published clinical studies and do not represent an ACCF endorsem*nt or evaluation of these products.
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