Heart Health

10-year risk 3% to under 5%

Your situation (severe hypercholesterolemia short-circuits the risk score) 10-yr risk 3–5% (borderline)

Routing steprisk-borderlineNo one has reached this rule yet

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

This is a routing step: it says nothing itself, and decides which rule applies next. For the example person, that is Borderline risk with a risk enhancer, Calcium score not measured and hs-CRP not measured.

An example person who reaches it

“Borderline risk + high Lp(a)” — an illustrative profile, not a real user.

58-year-old manBP 132/82LDL 140Lp(a) 78 mg/dL10-yr PREVENT-ASCVD 4.9%

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 risk 3–5% (borderline) ← this rule
  3. A risk-enhancing factor that counts? (weighted — a single unconfirmed hs-CRP does not count until repeated)One or more present
  4. Coronary artery calcium (CAC) score? (further testing beyond basic labs)Not measured
  5. hs-CRP ≥2 mg/L, confirmed on a repeat test? (further testing beyond basic labs)Not measured

Where it sits

Asked after: No known cardiovascular disease

Then asks: A risk-enhancing factor that counts? (weighted — a single unconfirmed hs-CRP does not count until repeated)

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

Then asks: hs-CRP ≥2 mg/L, confirmed on a repeat test? (further testing beyond basic labs)

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

For practising clinicians. Endorse it, propose a change, or dispute it. We verify every reviewer before a review is shown, and a review stays attached to the version of the rule you saw — if the rule changes, the page says so. You'll be asked to declare any relevant interests; they're shown with your review.

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Runs in lib/engine/lipidPathway.ts as risk-borderline.