From the Guidelines
The new ASCVD risk calculator differs from the old one in its approach to age, using a "risk age" rather than chronological age, which leads to more personalized risk assessments and treatment decisions. The old calculator often overestimated risk in older adults and underestimated it in younger individuals with significant risk factors due to the dominant role of age in the calculation 1. In contrast, the new calculator calculates a "cardiovascular age" or "risk age" that better reflects a person's actual risk profile based on their modifiable risk factors, such as blood pressure, cholesterol levels, smoking status, and diabetes 1.
This change is significant because it allows for more accurate assessments of cardiovascular risk, particularly in younger patients with significant risk factors and healthy older adults who may not be automatically categorized as high-risk simply due to their age 1. The new approach recognizes that age-related risk is more nuanced and should be considered alongside other modifiable risk factors for a more accurate assessment of cardiovascular risk.
Key points to consider when using the new ASCVD risk calculator include:
- The calculator is recommended for adults 40 to 75 years of age, with routine assessment of traditional cardiovascular risk factors and calculation of 10-year risk of ASCVD using the pooled cohort equations (PCE) 1.
- For adults 20 to 39 years of age, assessment of traditional ASCVD risk factors is recommended at least every 4 to 6 years, with consideration of lifetime or 30-year ASCVD risk estimation 1.
- The new calculator may lead to more appropriate risk scores for younger patients with significant risk factors and healthy older adults, allowing for more personalized treatment decisions, particularly regarding statin therapy initiation 1.
Overall, the new ASCVD risk calculator provides a more nuanced approach to assessing cardiovascular risk, taking into account the complexities of age-related risk and the importance of modifiable risk factors in determining an individual's actual risk profile 1.
From the Research
Difference between Old and New ASCVD Risk Score for Age
- The provided studies do not directly compare the old and new ASCVD risk scores for age, but they discuss the importance of assessing ASCVD risk and the factors that influence it 2, 3, 4, 5, 6.
- The studies highlight the use of traditional 10-year risk calculators, such as the one mentioned in 3, and the consideration of risk-enhancing factors, including lipoprotein(a) and subclinical atherosclerosis testing, to refine ASCVD risk assessment.
- The updated SMART2 algorithm, discussed in 6, provides a tool for estimating the 10-year risk of recurrent ASCVD events in patients with established ASCVD, but it does not specifically address the difference between old and new ASCVD risk scores for age.
- The studies emphasize the importance of accurate ASCVD risk assessment for targeted preventive therapies and personalized treatment approaches 3, 5, 6.
- However, there is no direct comparison or discussion of the differences between the old and new ASCVD risk scores for age in the provided studies, suggesting that this specific information may not be available in the given evidence.