RapidASCVD vs CV Risk Estimation

RapidASCVD accurately estimates 10-year ASCVD (atherosclerotic cardiovascular disease). The user interface has been optimized for speed so that busy clinicians are able to quickly calculate ASCVD scores for patients in the fastest amount of time possible -- usually within about 10-15 seconds. ASCVD risk is the estimated probability of a patient having a first-time (primary) event of coronary heart disease (such as myocardial infarction), cerebrovascular disease (such as stroke), and peripheral arterial disease. This estimate is not appropriate for use in patients who have already had one of these cardiovascular events. RapidASCVD has been extensively tested for accuracy with the pooled cohort equations (2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. doi: 10.1161/​01.cir.0000437741.48606.98), which is derived from the following variables: • Age • Total cholesterol • HDL cholesterol • Systolic blood pressure • Sex • Race • Presence of antihypertensive therapy • History of diabetes mellitus • Current smoking status The risk estimate is consistent with the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease (doi: 10.1161/CIR.0000000000000678), acknowledging that many other cardiovascular risk factors exist that are not present in the ASCVD risk calculation. This clinical tool is intended to be used in conjunction with reasonable clinical judgment.

This app is for CLINICIANS, not the lay public. The CV Risk app presents clinicians with three valuable 10-year cardiovascular event risk calculators to serve clinicians and learners in primary prevention of cardiovascular disease. It is for clinicians only, not the lay public. The calculators are Framingham 2008, ASCVD 2013, and the revised pooled cohort equations ASCVD of 2018. The app addresses such common questions as: • What is the ASCVD 10-year CV risk for a 57 year old male hypertensive smoker with a given set of lipid and blood pressure numbers? • What’s the magnitude of impact of a patient on their own improving their cholesterol by 11, 27, or 41 points? • For a poorly controlled hypertensive smoker with a 10-year risk of 31.3%, how impactful would improved blood pressure control or smoking cessation be? • How impactful is a cholesterol of 220 on a given patient's risk at 35 vs. 55 vs. 75 years old? • I hear that ASCVD 2013 overestimates risk, particularly for black adults? True? What about the revised pooled cohort equations of 2018? The app explicitly does not include treatment thresholds, LDL targets, estimates of impact of therapy, coronary calcium scoring, etc. I wanted the cleanest simplest tool possible for evaluating and discussing cardiovascular risk with all the other more subjective, controversial stuff out of the way. This app is written and intended for practicing clinicians like internists and family physicians; for resident physician trainees; for medical students; and of course for other clinician colleagues like NP's and PA's. Cardiologists could use this app, but you folks are focused on secondary prevention, which is an entirely different ballgame. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.