Cholesterol Guidelines 2013

10-year Hard ASCVD risk for Persons Aged 40 - 75

	White	African American
Female
Male
Not used in model:
Triglycerides	mg/dL
Diastolic BP	mm Hg
non-HDL cholesterol: ***** mg/dL Estimated LDL cholesterol: ***** mg/dL
Height (inches):		Weight (lb):

Age	yr
Total Cholesterol	mg/dL
HDL Cholesterol	mg/dL
Antihypertensive treatment?
Systolic BP	mm Hg
Current Smoker?
Diabetes?

*****

Hard ASCVD risk is defined as defined as first occurrence nonfatal and fatal MI, and nonfatal and fatal stroke

Algorithm is from Appendix 4 of:
2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
J Am Coll Cardiol. 2013;():. doi:10.1016/j.jacc.2013.11.005
Available on the Web at: http://content.onlinejacc.org/article.aspx?articleid=1770220

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Use at own risk.

Parameter	ln(age)	ln²(age)	ln(TC)	ln(age) x ln(TC)	ln(HDL)	ln(age) x ln(HDL)	log(SBP) (treated)	log(age) x log(SBP) (treated)	log(SBP) (untreated)	log(age) x log(SBP) (untreated)	Current Smoker	log(age) x current smoker	Diabetes
Parameter Coefficient
Calculated Value
Coefficient x Value

Sum of products
Mean sum of products
Baseline Survival

Major Recommendations for Statin Therapy

	LDL < 70	LDL 70-189			LDL ≥ 190
Age 21-39	Clinical ASCVD: High-intensity statin				High-intensity statin
Age 40-75	Clinical ASCVD: High-intensity statin	Clinical ASCVD: High-intensity statin
			No DM	DM
		10-y risk ≤ 7.5%	Recalculate risk 4 - 6 years	Moderate-intensity statin
		10-y risk > 7.5%	Moderate- or High- intensity statin	High-intensity statin
Age > 75	Clinical ASCVD: Moderate-intensity statin
Clinical ASCVD includes acute coronary syndromes, history of MI, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, or peripheral arterial disease presumed to be of atherosclerotic origin.

High-Intensity Statin Therapy	Moderate-Intensity Statin Therapy	Low-Intensity Statin Therapy
Daily dose lowers LDL-C on average, by approximately ≥ 50%	Daily dose lowers LDL-C on average, by approximately 30% to 50%	Daily dose lowers LDL-C on average, by < 30%
Atorvastatin (40) 80 mg Rosuvastatin 20 (40) mg	Atorvastatin 10 (20) mg Rosuvastatin (5) 10 mg Simvastatin 20-40 mg Pravastatin 40 (80) mg Lovastatin 40 mg Fluvastatin 40 mg bid Fluvastatin XL 80 mg Pitavastatin 2 - 4 mg	Pravastatin 10-20 mg Lovastatin 20 mg Simvastatin 10 mg Fluvastatin 20 - 40 mg Pitavastatin 1 mg
Statins and doses that are approved by the U.S. FDA but were not tested in the clinical trials reviewed are listed in italics

From Figure 2 and Table 5 of:
2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Circulation. 2013;01.cir.0000437738.63853.7a
Published online before print November 12 2013, doi:10.1161/01.cir.0000437738.63853.7a
Available on the Web at: http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a.citation

TG, mg/dL	Non-HDL-C, mg/dL
TG, mg/dL	<100	100-129	130-159	160-189	190-219	>219
7 - 49	3.5	3.4	3.3	3.3	3.2	3.1
50 - 56	4.0	3.9	3.7	3.6	3.6	3.4
57 - 61	4.3	4.1	4.0	3.9	3.8	3.6
62 - 66	4.5	4.3	4.1	4.0	3.9	3.9
67 - 71	4.7	4.4	4.3	4.2	4.1	3.9
72 - 75	4.8	4.6	4.4	4.2	4.2	4.1
76 - 79	4.9	4.6	4.5	4.3	4.3	4.2
80 - 83	5.0	4.8	4.6	4.4	4.3	4.2
84 - 87	5.1	4.8	4.6	4.5	4.4	4.3
88 - 92	5.2	4.9	4.7	4.6	4.4	4.3
93 - 96	5.3	5.0	4.8	4.7	4.5	4.4
97 - 100	5.4	5.1	4.8	4.7	4.5	4.3
101 - 105	5.5	5.2	5.0	4.7	4.6	4.5
106 - 110	5.6	5.3	5.0	4.8	4.6	4.5
111 - 115	5.7	5.4	5.1	4.9	4.7	4.5
116 - 120	5.8	5.5	5.2	5.0	4.8	4.6
121 - 126	6.0	5.5	5.3	5.0	4.8	4.6
127 - 132	6.1	5.7	5.3	5.1	4.9	4.7
133 - 138	6.2	5.8	5.4	5.2	5.0	4.7
139 - 146	6.3	5.9	5.6	5.3	5.0	4.8
147 - 154	6.5	6.0	5.7	5.4	5.1	4.8
155 - 163	6.7	6.2	5.8	5.4	5.2	4.9
164 - 173	6.8	6.3	5.9	5.5	5.3	5.0
174 - 185	7.0	6.5	6.0	5.7	5.4	5.1
186 - 201	7.3	6.7	6.2	5.8	5.5	5.2
202 - 220	7.6	6.9	6.4	6.0	5.6	5.3
221 - 247	8.0	7.2	6.6	6.2	5.9	5.4
248 - 292	8.5	7.6	7.0	6.5	6.1	5.6
293 - 399	9.5	8.3	7.5	7.0	6.5	5.9
400 - 13975	11.9	10.0	8.8	8.1	7.5	6.7

*****

From Figure 2 of:
Martin SS, Blaha MJ, Elshazly MB, et al. Comparison of a Novel Method vs the Friedewald Equation for Estimating Low-Density Lipoprotein Cholesterol Levels From the Standard Lipid Profile.
JAMA. 2013;310(19):2061-2068. doi:10.1001/jama.2013.280532.
Not available on the Web without forking over $$.

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