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Therapeutic Calculations Example 4

December 22, 2018

In this clip, we explain how to estimate 10-year cardiovascular disease risk (ASCVD) and that through the Medscape application on mobile devices.

This clip is from a series of clips presented by Dr. Eyad Qunaibi, PhD in Pharmacology from the American University of Houston, and a lecturer and researcher in Pharmacology, Treatments, and Pharmacokinetics at Jerash University.. Useful for pharmacy, medicine, and nursing students, and then for the general public interested in obtaining reliable therapeutic information.

Introduction to Using the "Medscape" Application

Peace be upon you, brothers. This is the third segment discussing the use of the "Medscape" application, specifically the Calculators section, through which we perform some beneficial calculations.

In this segment, we will discuss how to calculate the cardiovascular risk assessment (ACC/AHA Cardiovascular Risk Assessment), also known as the 10-Year Cardiovascular Risk Assessment. This calculation aims to predict the likelihood of the patient suffering a stroke or heart attack within the next ten years.

Determining this number is very important; according to some health organizations, it is what determines whether it is appropriate to give the patient a low dose of aspirin (Low-dose Aspirin), and we also use it to determine whether the patient should be treated with blood pressure medication or not.

Practical Example of a Medical Case

Let's apply this to a practical example:

Gender and Age: Male, 64 years old.
Health Condition: Has diabetes, and is a smoker.
Lipid Tests:
- Total Cholesterol: 220 mg/dL.
- HDL Cholesterol: 33.8 mg/dL.
Blood Pressure: His blood pressure has been measured several times in the clinic, with an average reading of 135/85 mmHg.

According to the guidelines (Guidelines), if the blood pressure is between 135/85, we need to calculate the 10-year cardiovascular risk (10-year ASCVD Risk). If the percentage is high (greater than or equal to 10%), drug treatment should be started. If it is lower, we can stick to non-pharmacological therapy (Non-pharmacological therapy).

Our patient actually falls into this category; his systolic blood pressure (Systolic) is between 130-139, and his diastolic blood pressure (Diastolic) is between 80-89.

How to Access the Calculator via the Medscape Website

It is important to note that this specific calculator is not available in the "Medscape" mobile application, so we need to access it via the browser on the "Medscape" website (Medscape Website).

Go to the Drugs and Diseases section.
Choose Tools, then Calculators.
From the list of calculator sections, select the third item: (2013 ACC/AHA Cardiovascular Risk).

Entering Data and Extracting Results

After accessing the calculator, we fill in the data:

Race: Choose Other as it is neither African nor Caucasian.
Gender: Male.
Age: 64 years.
Total Cholesterol: 220.
HDL Cholesterol: 33.8.
Systolic Blood Pressure: 135.
Is he taking blood pressure medication? No (No).
Does he suffer from diabetes? Yes (Yes).
Is he a smoker? Yes (Yes).

Result: The percentage 41% appeared. Since the risk of injury over the next ten years is more than 10%, he should be treated with blood pressure medication.

Importance of Awareness and Lifestyle Change

We can use these numbers to encourage patients; for example, if we tell the patient that if he quits smoking, the percentage will decrease to 30%. If he were not diabetic, the percentage would decrease to 17.3%.

This application is very useful to try with family members to know the likelihood of their exposure to these diseases, God forbid, and to encourage people to quit smoking, which greatly increases the likelihood of injury.

Final Note: There are other applications such as (ASCVD Plus), but dealing with them may not be as comfortable. As for the (Framingham 10-year calculator), it may give different results, so we rely on the (ACC/AHA) standards.