Total
Cardiovascular Risk Assessment
Sources:
ACC/AHA scientific statement- 1999; National Cholesterol Education Program
Adult Treatment Panel III (NCEP ATP III)- clinical-practice guideline
Effective primary and secondary prevention of Coronary Artery Disease (CAD)
requires the complete assessment of the CAD risk.
This
serves three purposes:
- Identification of high-risk patients for immediate attention and
intervention.
- Motivation of patients to adhere to risk reduction therapies.
- Modification of intensity of risk-reduction efforts (especially
lipid-lowering interventions) based on the total risk assessment.
There
are three risk categories:
- Low-risk: < 10% ten-year-risk for CAD.
- Intermediate-risk: 10-20% ten-year-risk for CAD.
- High-risk: >20% ten-year-risk for CAD.
Determining The Patients
Risk Category
1. Review the patients’
problem list. Does the patient have a documented cardiovascular disease (Coronary
Artery Disease, Symptomatic Carotid Artery Disease, Cerebrovascular
Disease, Peripheral Vascular Disease, Abdominal Aortic Aneurysm) or
Diabetes Mellitus? |
↓ |
↓ |
No |
Yes |
↓ |
↓ |
2. Does the patient have 0-1 major risk factors? See Risk Factors. |
High-Risk Category |
↓ |
↓ |
|
No |
Yes |
→ |
Low-Risk Category |
↓ |
|
3. Calculate the patients total ten-year-risk: Heart Disease Risk. |
↓ |
4. Determine-risk category |
|