What is the role of a cardiovascular risk assessment in the workup of metabolic syndrome?

Updated: Oct 17, 2019
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

New guidelines on the assessment of cardiovascular risk, released in late 2013 by the American Heart Association/American College of Cardiology (AHA/ACC), recommend use of a revised calculator for the risk of developing a first atherosclerotic cardiovascular disease (ASCVD) event, which is defined as one of the following in a person who was initially free from ASCVD [82] :

  • Nonfatal myocardial infarction

  • Death from coronary heart disease

  • Stroke (fatal or nonfatal)

The calculator uses 9 clinical and laboratory risk factors to determine 10-year and lifetime risk.

For patients 20-79 years of age who do not have existing clinical ASCVD, the guidelines recommend assessing clinical risk factors every 4-6 years. For patients with low 10-year risk (< 7.5%), the guidelines recommend assessing 30-year or lifetime risk in patients 20-59 years old. Regardless of the patient’s age, clinicians should communicate risk data to the patient and refer to the AHA/ACC lifestyle guidelines, which cover diet and physical activity. For patients with elevated 10-year risk, clinicians should communicate risk data and refer to the AHA/ACC guidelines on blood cholesterol and obesity. [82]


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