ABC | Volume 113, Nº4, October 2019

Updated Updated Cardiovascular Prevention Guideline of the Brazilian Society Of Cardiology – 2019 Arq Bras Cardiol. 2019; 113(4):787-891 Chart 1.4 – Patients at low cardiovascular risk according to the Department of Atherosclerosis of the Brazilian Society of Cardiology 7 • Men with an overall risk score < 5% • Women with an overall risk score < 5% Chart 1.5 – Score according to overall risk for women 2 Score Age (years) HDL-c TC SBP (untreated) SBP (treated) Smoking Diabetes -3 < 120 -2 60+ -1 50-59 < 120 0 30-34 45-49 < 160 120-129 No No 1 35-44 160-199 130-139 2 35-39 < 35 140-149 120-139 3 200-239 130-139 Yes 4 40-44 240-279 150-159 Yes 5 45-49 280+ 160+ 140-149 6 150-159 7 50-54 160+ 8 55-59 9 60-64 10 65-69 11 70-74 12 75+ HDL-c: high-density lipoprotein-cholesterol; SBP: systolic blood pressure; TC: total cholesterol. Therefore, adults considered at low CV risk are those aged 30 to 74 years, of both genders, whose risk for CV events calculated by GRS is lower than 5% in 10 years 6,7 (Chart 1.4). Although the calcium score is not recommended for low-risk patients, non-diabetic individuals at moderate risk, without a family history of premature coronary disease, who have a zero calcium score can be considered at low risk and postpone the start of the cholesterol-lowering therapy with statins. 8 Aggravating risk factors are not used in patients considered at low CV risk. The North American guideline of 2018 considers restratifying moderate risk to low in patients with zero calcium score (non-diabetics and without a family history of premature coronary disease). 8 Charts 1.5, 1.6, 1.7, and 1.8 present the GRS for men and women in 10 years. Chart 1.6 – Overall risk for women in 10 years 2 Score Risk (%) Score Risk (%) ≤ -2 < 1 13 10.0 -1 1.0 14 11.7 0 1.2 15 13.7 1 1.5 16 15.9 2 1.7 17 18.5 3 2.0 18 21.6 4 2.4 19 24.8 5 2.8 20 28.5 6 3.3 21+ > 30 7 3.9 8 4.5 9 5.3 10 6.3 11 7.3 12 8.6 Table 1.1 summarizes the recommendations for cardiovascular risk stratification. 797