CVD Risk Estimator Plus vs CV Risk Estimation

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.

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.