function calculateRisk() {
var age = parseFloat(document.getElementById("age").value);
var sex = document.querySelector('input[name="sex"]:checked').value;
var race = document.querySelector('input[name="race"]:checked').value;
var totalCholesterol = parseFloat(document.getElementById("totalCholesterol").value);
var hdlCholesterol = parseFloat(document.getElementById("hdlCholesterol").value);
var systolicBP = parseFloat(document.getElementById("systolicBP").value);
var htnTreatment = document.querySelector('input[name="htnTreatment"]:checked').value === 'yes';
var smoker = document.querySelector('input[name="smoker"]:checked').value === 'yes';
var diabetes = document.querySelector('input[name="diabetes"]:checked').value === 'yes';
var resultDiv = document.getElementById("result");
// Input validation
if (isNaN(age) || age 79) {
resultDiv.innerHTML = "Please enter a valid age between 40 and 79.";
return;
}
if (isNaN(totalCholesterol) || totalCholesterol 320) {
resultDiv.innerHTML = "Please enter a valid Total Cholesterol (130-320 mg/dL).";
return;
}
if (isNaN(hdlCholesterol) || hdlCholesterol 100) {
resultDiv.innerHTML = "Please enter a valid HDL Cholesterol (20-100 mg/dL).";
return;
}
if (isNaN(systolicBP) || systolicBP 200) {
resultDiv.innerHTML = "Please enter a valid Systolic Blood Pressure (90-200 mmHg).";
return;
}
// Log transformations
var ln_age = Math.log(age);
var ln_totalCholesterol = Math.log(totalCholesterol);
var ln_hdlCholesterol = Math.log(hdlCholesterol);
var ln_systolicBP = Math.log(systolicBP);
var sum_of_predictors = 0;
var baseline_survival = 0;
var mean_risk_score = 0;
// Coefficients based on 2013 ACC/AHA Pooled Cohort Equations
// Source: https://www.ahajournals.org/doi/suppl/10.1161/01.cir.0000437741.48606.98/DC1/APPENDIX_2.pdf
if (sex === 'male' && race === 'other') { // Non-Hispanic White Men
var s_0 = 0.9144; // Baseline survival
var mean_xb = 61.18; // Mean of sum of predictors
var coeff_age = 12.344;
var coeff_ln_tc = 11.853;
var coeff_ln_hdl = -2.664;
var coeff_ln_age_ln_hdl = 0.000; // Not used in this specific cohort for interaction
var coeff_ln_sbp_untreated = 2.822;
var coeff_ln_sbp_treated = 2.764;
var coeff_ln_age_ln_sbp_untreated = 0.000; // Not used
var coeff_ln_age_ln_sbp_treated = 0.000; // Not used
var coeff_smoker = 0.523;
var coeff_diabetes = 0.642;
sum_of_predictors =
coeff_age * ln_age +
coeff_ln_tc * ln_totalCholesterol +
coeff_ln_hdl * ln_hdlCholesterol +
(htnTreatment ? coeff_ln_sbp_treated : coeff_ln_sbp_untreated) * ln_systolicBP +
(smoker ? coeff_smoker : 0) +
(diabetes ? coeff_diabetes : 0);
baseline_survival = s_0;
mean_risk_score = mean_xb;
} else if (sex === 'female' && race === 'other') { // Non-Hispanic White Women
var s_0 = 0.9665; // Baseline survival
var mean_xb = -29.799; // Mean of sum of predictors
var coeff_age = -29.799;
var coeff_ln_age_sq = 4.884; // Age squared interaction
var coeff_ln_tc = 13.540;
var coeff_ln_hdl = -13.578;
var coeff_ln_age_ln_hdl = 3.116;
var coeff_ln_sbp_untreated = 2.013;
var coeff_ln_sbp_treated = 1.957;
var coeff_ln_age_ln_sbp_untreated = 0.000; // Not used
var coeff_ln_age_ln_sbp_treated = 0.000; // Not used
var coeff_smoker = 0.892;
var coeff_diabetes = 0.627;
sum_of_predictors =
coeff_age * ln_age +
coeff_ln_age_sq * Math.pow(ln_age, 2) +
coeff_ln_tc * ln_totalCholesterol +
coeff_ln_hdl * ln_hdlCholesterol +
coeff_ln_age_ln_hdl * ln_age * ln_hdlCholesterol +
(htnTreatment ? coeff_ln_sbp_treated : coeff_ln_sbp_untreated) * ln_systolicBP +
(smoker ? coeff_smoker : 0) +
(diabetes ? coeff_diabetes : 0);
baseline_survival = s_0;
mean_risk_score = mean_xb;
} else if (sex === 'male' && race === 'africanAmerican') { // African American Men
var s_0 = 0.8954; // Baseline survival
var mean_xb = 19.542; // Mean of sum of predictors
var coeff_age = 2.469;
var coeff_ln_tc = 0.302;
var coeff_ln_hdl = -0.712;
var coeff_ln_age_ln_hdl = 0.000; // Not used
var coeff_ln_sbp_untreated = 1.809;
var coeff_ln_sbp_treated = 1.761;
var coeff_ln_age_ln_sbp_untreated = 0.000; // Not used
var coeff_ln_age_ln_sbp_treated = 0.000; // Not used
var coeff_smoker = 0.654;
var coeff_diabetes = 0.577;
sum_of_predictors =
coeff_age * ln_age +
coeff_ln_tc * ln_totalCholesterol +
coeff_ln_hdl * ln_hdlCholesterol +
(htnTreatment ? coeff_ln_sbp_treated : coeff_ln_sbp_untreated) * ln_systolicBP +
(smoker ? coeff_smoker : 0) +
(diabetes ? coeff_diabetes : 0);
baseline_survival = s_0;
mean_risk_score = mean_xb;
} else if (sex === 'female' && race === 'africanAmerican') { // African American Women
var s_0 = 0.9533; // Baseline survival
var mean_xb = 17.114; // Mean of sum of predictors
var coeff_age = 17.114;
var coeff_ln_tc = 0.940;
var coeff_ln_hdl = -18.920;
var coeff_ln_age_ln_hdl = 4.475;
var coeff_ln_sbp_untreated = 29.291;
var coeff_ln_sbp_treated = 27.820;
var coeff_ln_age_ln_sbp_untreated = -6.432;
var coeff_ln_age_ln_sbp_treated = -6.094;
var coeff_smoker = 0.691;
var coeff_diabetes = 0.874;
sum_of_predictors =
coeff_age * ln_age +
coeff_ln_tc * ln_totalCholesterol +
coeff_ln_hdl * ln_hdlCholesterol +
coeff_ln_age_ln_hdl * ln_age * ln_hdlCholesterol +
(htnTreatment ? (coeff_ln_sbp_treated * ln_systolicBP + coeff_ln_age_ln_sbp_treated * ln_age * ln_systolicBP) :
(coeff_ln_sbp_untreated * ln_systolicBP + coeff_ln_age_ln_sbp_untreated * ln_age * ln_systolicBP)) +
(smoker ? coeff_smoker : 0) +
(diabetes ? coeff_diabetes : 0);
baseline_survival = s_0;
mean_risk_score = mean_xb;
} else {
resultDiv.innerHTML = "Error: Could not determine risk cohort.";
return;
}
var risk_score_exponent = sum_of_predictors – mean_risk_score;
var ten_year_risk = (1 – Math.pow(baseline_survival, Math.exp(risk_score_exponent))) * 100;
resultDiv.innerHTML = "Your estimated 10-Year ASCVD Risk is:
Understanding the ACC/AHA ASCVD 10-Year Risk Calculator
The American College of Cardiology (ACC) and American Heart Association (AHA) Atherosclerotic Cardiovascular Disease (ASCVD) 10-Year Risk Calculator is a crucial tool used by healthcare professionals to estimate a person's risk of having a heart attack or stroke within the next 10 years. This calculator is based on the Pooled Cohort Equations, which were developed from extensive research involving diverse populations.
Why is this calculator important?
Knowing your 10-year ASCVD risk helps you and your doctor make informed decisions about preventive care. For individuals with elevated risk, lifestyle modifications (such as diet and exercise) and medical interventions (like statin therapy or blood pressure medication) can be discussed to reduce the likelihood of future cardiovascular events. It shifts the focus from treating individual risk factors in isolation to assessing overall cardiovascular risk.
Who should use this calculator?
This calculator is primarily intended for adults aged 40 to 79 who do not currently have ASCVD (e.g., no history of heart attack, stroke, or peripheral artery disease) and are not already on high-intensity statin therapy. It's a tool for primary prevention, helping to identify individuals who might benefit most from preventive strategies.
Key Risk Factors Included:
- Age: Risk generally increases with age.
- Sex: Men and women have different risk profiles.
- Race: African Americans have a different risk equation due to distinct risk factor prevalence and outcomes.
- Total Cholesterol & HDL Cholesterol: These lipid levels are key indicators of cardiovascular health.
- Systolic Blood Pressure: High blood pressure is a major risk factor.
- On Hypertension Treatment: Indicates controlled or uncontrolled hypertension.
- Smoker Status: Smoking significantly increases ASCVD risk.
- Diabetes Status: Diabetes is a strong independent risk factor for cardiovascular disease.
Interpreting Your Results:
The calculator provides a percentage representing your estimated 10-year risk. Generally, risk categories are:
- Low Risk: <5%
- Borderline Risk: 5% to <7.5%
- Intermediate Risk: 7.5% to <20%
- High Risk: ≥20%
These categories guide discussions with your healthcare provider about the intensity of risk-reduction strategies. For example, individuals with intermediate or high risk might be recommended for statin therapy, while those with borderline risk might consider it based on other factors.
Important Disclaimer:
This calculator provides an estimate of risk and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health or treatment. The calculator does not account for all possible risk factors, and clinical judgment is always paramount.
Example Calculation:
Let's consider a 55-year-old non-African American male with:
- Total Cholesterol: 200 mg/dL
- HDL Cholesterol: 50 mg/dL
- Systolic Blood Pressure: 130 mmHg (not on treatment)
- Non-smoker
- No diabetes
Using the calculator with these inputs, the estimated 10-Year ASCVD Risk would be approximately 5.3%. This would place him in the borderline risk category, prompting a discussion with his doctor about lifestyle changes and potentially other risk-enhancing factors.