CVD Risk Estimator Plus vs MESA Risk Score

This clinical decision-support app is intended for use by healthcare professionals and unifies two cardiovascular prevention tools: the 2013 ACC/AHA Pooled Cohort Equations (previously known as the ASCVD Risk Estimator) and the American Heart Association’s PREVENT™ Calculator. Combining traditional ASCVD risk modeling with modern cardiovascular-kidney-metabolic (CKM)-inclusive risk equations, CVD Risk Estimator Plus supports comprehensive, personalized cardiovascular disease (CVD) risk assessment and clinician-guided decision-making. 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. CVD Risk Estimator Plus computes risk estimates using: • 2013 ASCVD Pooled Cohort Equations (PCE), which calculate 10-year and lifetime risk of atherosclerotic cardiovascular disease using age, sex, race, blood pressure, cholesterol profile, diabetes status, and smoking status. • 2023 PREVENT™ Equations, which estimate 10- and 30-year risk for total CVD, ASCVD, and heart failure (HF), incorporating kidney and metabolic health measures such as BMI and estimated glomerular filtration rate (eGFR), and supporting optional predictors including urine albumin creatinine ratio (UACR), hemoglobin A1c (HbA1c), and social deprivation index (SDI). Clinicians can toggle between Pooled Cohort and PREVENT™ risk trajectories to support guideline-aligned prevention discussions. This clinical decision support app provides: • Risk category classification (low, borderline, intermediate, high). • Personalized guidance informed by published guidelines, including statin therapy considerations, lifestyle interventions, and risk-enhancing clinical factors. • Export functionality supporting print and email of results for documentation and patient communication. • Resources page with related tools and informational materials for clinicians and patients, including links to source guidelines and reference documents.

The Multi-Ethnic Study of Atherosclerosis (MESA) is a study of the characteristics of subclinical cardiovascular disease (disease detected non-invasively before it has produced clinical signs and symptoms) and the risk factors that predict progression to clinically overt cardiovascular disease or progression of the subclinical disease. MESA researchers study a diverse, population-based sample of 6,814 asymptomatic men and women aged 45-84 from six field centers across the United States. Approximately 38 percent of the recruited participants are white, 28 percent African-American, 22 percent Hispanic, and 12 percent Asian, predominantly of Chinese descent. The first examination took place over two years, from July 2000-July 2002. It was followed by three examination periods that were 17-20 months in length, and a fifth exam April 2010 – January 2012. Participants are contacted every 9 to 12 months throughout the study to assess clinical morbidity and mortality. The final 18 months of the study are dedicated to close out and data analysis and publication. The MESA CHD Risk Score is the first risk scoring tool to incorporate coronary artery calcium scores. The MESA CHD Risk Score can be used to help guide the intensity of preventive therapies such as diet, exercise, aspirin, blood pressure and cholesterol therapies. The results and recommendations provided by this application are intended to inform but do not replace clinical judgement. Therapeutic options should be individualized and determined after discussion between the patient and their care provider. This app was developed under the direction of the MESA Executive Committee by Ted W. James, MD