Question

Jane is a 53-year old white female. Her medical history includes Type 2 diabetes for which she takes metformin, hypertension treated with Lasix, obesity, and obstructive sleep apnea. Previously, she smoked a half pack of cigarettes per day, but stopped 2 years ago. During her recent checkup, Jane had a blood pressure of 148/90. Her lipid profile revealed a total cholesterol of 230 mg/dL, HDL 35 mg/dL, and LDL 175 mg/dL.

        Jane’s 10-year ASCVD risk is _____% or __________ risk

Answer 1

ASCVD Statin Benefit Groups Heart healthy lifestyle habits are the foundation of ASCVD prevention In individuals not receiving cholesterol-lowering drug therapy. recalculate estimated 10-y ASCVD risk every 4-0 y in individuals aged 40-75 y without clinical ASCVD or diabetes and with LDL-C 70-180 mg/dL. Age 75 y High-intensity statin (Moderate intensity statin if not candidate for high-intensity statin) Adults age > 21 y and a candidate for statin therapy Yes Clinical ASCVD Age >75 y OR if not candidate for high-tensity statin Moderate-intensity statin Definitions of High- and Moderate-Intensity Statin Therapy See Table 5) LDL-C 2190 mg/dL High-intensity statin (Moderate-intensity statin if not candidate for high-intensity statin) High Moderate Daily dose lowers | Daily dose lowers LDL C by appox. LDL C by appox. 250% 30% to 50% Moderate-intensity statin Diabetes Type 1 or 2 Age 40-75 y Estimated 10 y ASCVD nsk 27.6% High intensity statin NO Estimate 10-y ASCVD Risk with Pooled Cohort Equations 27.5% estimated 10-y ASCVD risk and age 40-75 y Moderate-to-high intensity statin No ASCVD prevention benefit of statin therapy may be less clear in other groups In selected individuals, consider additional factors influencing ASCVD risk and potential ASCVD risk benefits and adverse effects, drug-drug interactions. and patient preferences for statin treatment

53 years Age This calculator only applies to individuals 40-75 years of age. Diabetes - No Yes Sex Female Male Race White African American Other Smoker - No Yes Total cholesterol 230 mg/dL — HDL cholesterol 35 mg/dL — Systolic blood pressure 148 mm Hg

Treatment for hypertension No Yes High-intensity statin recommended because of known diabetes and 10-year risk 27.5%. If LDL <70mg/dl (1.81 mmol/L), additional factors like lifestyle and risk-benefits can be considered before starting statins. To view statin dosages by intensity, see Evidence section. 10.5% Risk of cardiovascular event (coronary or stroke death or non-fatal MI or stroke) in next 10 years. 1.1% 10-year cardiovascular risk if risk factors were optimal.