Cardiovascular disease in women module iii risk assessment tool
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Cardiovascular Disease in Women Module III: Risk Assessment Tool. Risk Stratification: . High Risk Diabetes mellitus Documented atherosclerotic disease Established coronary heart disease Peripheral arterial disease Cerebrovascular disease Abdominal aortic aneurysm

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Cardiovascular Disease in WomenModule III: Risk Assessment Tool


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Risk Stratification:

  • High Risk

    • Diabetes mellitus

    • Documented atherosclerotic disease

      • Established coronary heart disease

      • Peripheral arterial disease

      • Cerebrovascular disease

      • Abdominal aortic aneurysm

    • Includes many patients with chronic kidney disease, especially ESRD

    • 10-year Framingham global risk > 20%, or high risk based on another population-adapted global risk assessment tool

Source: Mosca 2007


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Risk Stratification:

  • At Risk:

    • > 1 major risk factors for CVD, including:

      • Cigarette smoking

      • Hypertension

      • Dyslipidemia

      • Family history of premature CVD (CVD at < 55 years in a male relative, or < 65 years in a female relative)

      • Obesity, especially central obesity

      • Physical inactivity

      • Poor diet

    • Metabolic syndrome

    • Evidence of subclinical coronary artery disease (eg coronary calcification), or poor exercise capacity on tredtmill test or abnormal heart rate recovery after stopping exercise

Source: Mosca 2007


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Definition of Metabolic Syndrome in Women

  • Abdominal obesity - waist circumference > 35 in.

  • High triglycerides ≥ 150mg/dL

  • Low HDL cholesterol < 50mg/dL

  • Elevated BP ≥ 130/85mm Hg

  • Fasting glucose ≥ 100mg/dL

Source: AHA/NHLBI 2005


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Risk Stratification:

  • Optimal risk:

    • No risk factors

    • Healthy lifestyle

    • Framingham global risk < 10%

Source: Mosca 2007


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Risk Stratification

  • Calculate 10 year risk for all patients with two or more risk factors that do not already meet criteria for CHD equivalent

  • Use electronic calculator for most precise estimate: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm

Source: Mosca 2004


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Source: http://www.nhlbi.nih.gov/about/framingham/riskabs.htm


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Source: http://www.nhlbi.nih.gov/about/framingham/riskabs.htm


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Downloadable Scoring Sheet for 10-year CHD event risk

  • The scoring sheet is available at: http://www.nhlbi.nih.gov/about/framingham/riskabs.htm

Source: www.nhlbi.nih.gov/about/framingham/riskabs.htm


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