IJCS | Volume 31, Nº5, September / October 2018

494 Figure 1: App layout with an example of 10-year and lifetime cardiovascular risk estimates. Azevedo et al. ASCVD risk estimator to estimate CVD risk Int J Cardiovasc Sci. 2018;31(5)492-498 Original Article With respected to related risk factors, there were 41 dyslipidemic, 39 hypertensive, 27 non-smoking and 21 diabetic patients. Data from the hospital admission report revealed that 26 patients had a FamH of CVD, including AMI, ischemic or hemorrhagic stroke, thromboembolism or sudden death; 19 did not have a family history of CVD; 28 did not know or this information was missing in the report (Table 1). Estimation of the 10-year risk score using the ASCVD Risk Estimator showed that 32% of patients were at high risk (n = 23), 26% at moderate risk (n = 19) and 42% at low risk (n = 30) (Graph 2). Table 2 describes percentages, relative risk (odds ratio – OR) and confidence interval obtained in the between- group comparisons (chi-square test). Considering the optimal risk factors defined by the ASCVD Risk Estimator, 52% (n = 12) of patients at high risk and 84% (n = 16) of patients at moderate risk had a risk lower than 10% with optimal risk factors. Discussion The ASCVD Risk Estimator, developed by the AHA/ ACC in 2013 grounded in the Framingham study, 8,9 evaluates the variables sex, age, ethnicity, total cholesterol and HDL levels, SBP, HBP and DM and smoking habits for the estimation of the 10-year cardiovascular risk. 8 Although the risk score proposed by the 2013 AHA/ ACC Guideline 7 considered several groups and large populations, only AMI (fatal and non-fatal) and stroke were considered CVDs. 7 Approximately 90% of patients with CVDs have at least one related risk factor. 10 In addition to the risk factors described in the Framingham study, other risk factors include obesity, alcohol consumption, stress, depression, low intake of vegetables and fruits, and irregular or no physical acitivity. 10 Also, some studies have correlated inflammatory markers, e.g. C-reactive protein and homocysteinewith the incidence of cardiovascular events and cardiovascular risk prediction. 11