|Recommendations||NHLBI Grade||NHLBI Evidence Statements||ACC/AHA COR||ACC/AHA LOE|
|Assessment of 10-Year Risk of a First Hard ASCVD Event|
|B (Moderate)||N/A||I||B (4–8)|
|E (Expert Opinion)||N/A||IIb||C|
|CQ1: Use of Newer Risk Markers After Quantitative Risk Assessment|
|E (Expert Opinion)||Appendix 4||IIb†||B (9–17)|
|N (No recommendation for or against)||Appendix 4||III: No Benefit†||B (12,16,18)|
|N (No recommendation for or against)||Appendix 4||—||—|
|CQ2: Long-Term Risk Assessment|
|B (Moderate)||Appendix 5|
|C (Weak)||Appendix 5|
A downloadable spreadsheet enabling estimation of 10-year and lifetime risk of ASCVD and a Web-based calculator is available at http://my.americanheart.org/cvriskcalculator and http://www.cardiosource.org/en/Science-And-Quality/Practice-Guidelines-and-Quality-Standards/2013-Prevention-Guideline-Tools.aspx.
ABI indicates ankle-brachial index; ACC, American College of Cardiology; AHA, American Heart Association; ApoB, apolipoprotein B; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; CAC, coronary artery calcium; CIMT, carotid intima-media thickness; CKD, chronic kidney disease; COR, Class of Recommendation; CQ, critical question, ES, evidence statement; hs-CRP, high-sensitivity C-reactive protein; LOE, Level of Evidence; NHLBI, National Heart, Lung, and Blood Institute; and —, not applicable.
↵∗ Derived from the ARIC (Atherosclerosis Risk in Communities) study (8), Cardiovascular Health Study (5), CARDIA (Coronary Artery Risk Development in Young Adults) study (7), and Framingham original and offspring cohorts (4,6).
↵† Based on new evidence reviewed during ACC/AHA update of evidence.
↵‡ Age, sex, total cholesterol, high-density lipoprotein cholesterol, systolic BP, use of antihypertensive therapy, diabetes, and current smoking.