Heart Health

10-year risk 5% to under 10%

Your situation (severe hypercholesterolemia short-circuits the risk score) 10-yr PREVENT-ASCVD 5–<10% (intermediate)

Recommendationrisk-5-to-10No one has reached this rule yet

Statin should be started; LDL-C <100, non-HDL-C <130 (30–49% reduction)

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Strongly recommended

    Statin therapy should be started, aiming for LDL-C below 100 mg/dL (and non-HDL-C below 130) — which usually means cutting your LDL by 30-49%.

    Expert guidelinesOfficial guidelines recommend it, based on trials plus expert judgment.

    ACC/AHAClass 1Level AESC/EASClass IIaLevel A
    Why, and the source

    Your estimated 10-year PREVENT-ASCVD risk is 5.6%, in the guideline's "intermediate" band of 5% to just under 10%. Worth being precise about the goal: the LDL target of 70 belongs to the high-risk group at 10% and above, not to this band. Treatment is clearly recommended for you; the target is 100.

    Where the guidelines stand

    ACC/AHA (US)

    ESC (Europe)

    • RecommendsClass IIaLevel A

      Pharmacological LDL-C lowering should be considered at moderate risk with LDL-C 100 mg/dL or higher. The ESC sorts risk with SCORE2, not the PREVENT equations used here, so the tiers line up only roughly.

      2025 ESC/EAS focused update on dyslipidaemias · Recommendation tables · class and level read from the guideline tables on 2026-09-30

    2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class 1 · Level A

An example person who reaches it

“Intermediate risk” — an illustrative profile, not a real user.

60-year-old manBP 136/84LDL 14210-yr PREVENT-ASCVD 5.6%

Their path through cholesterol

  1. Known ASCVD (prior heart attack, stroke, or revascularization)?No
  2. Your situation (severe hypercholesterolemia short-circuits the risk score)10-yr PREVENT-ASCVD 5–<10% (intermediate) ← this rule
  3. Coronary artery calcium (CAC) score? (further testing beyond basic labs)Not measured

Where it sits

Asked after: No known cardiovascular disease

Then asks: Coronary artery calcium (CAC) score? (further testing beyond basic labs)

Sources

Cited by the recommendations above.

What we are least sure of here

  • Q7Are 3% and 5% the right PREVENT-based bands? The load-bearing assumption of the whole product.

Review this rule

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Runs in lib/engine/lipidPathway.ts as risk-5-to-10.