Fam Pract Manag. 2014 Sep-Oct;21(5):32.
Author disclosures: no relevant financial affiliations disclosed.
The Cardiac Risk Assist app allows health care professionals to calculate 10-year and lifetime risks for atherosclerotic cardiovascular (CV) disease.
Source: Tin T.D. Nguyen, MD, Brody School of Medicine at East Carolina University
Platforms available: iOS 6.1 or later; designed for iOS 7
Pertinence to primary care practice: Treating adults with dyslipidemia is a core task for primary care clinicians. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol management guidelines shifted the emphasis from achieving low-density lipoprotein (LDL) goals to treating patients based on overall CV disease risks. Statins are the only class of lipid-lowering medications that have improved CV outcomes in randomized, controlled trials. This app lets busy clinicians quickly calculate a patient's 10-year and lifetime risk of CV events (including peripheral artery disease and stroke) and, if recommended, determine the intensity of prescribed statin.
Authoritativeness/accuracy/currency of information: CV risk estimates are based on the 2013 ACC/AHA guideline for treatment of blood cholesterol1 as well as the ACC/AHA guideline on assessing cardiovascular risk.2 The app was validated against the guideline's CV risk estimator3 using data from 100 randomized patients. Most estimates by the app were within 0.1 percent of the percentages calculated by the CV risk estimator. Of note, these guidelines have been endorsed by the AAFP with some qualifications.4 Most notably, the CV risk estimator has not been validated and may overestimate risk. Additionally, lowering the 10-year risk cutoff for treatment from 10 percent to 7.5 percent will increase the number of patients for whom statins are recommended.
Cost: Free to all users
Ease of use: Entering data into the calculator takes only a few seconds, and it can be refreshed with one touch. The menu at the bottom of the screen lets the user navigate quickly between the risk calculator, individualized treatment recommendations, and appropriate statin dosing. The app can only assess risk in patients who are 20 to 79 years old with a total cholesterol between 130–320 mg/dL, HDL between 20–100 mg/dL, and systolic blood pressure between 90–200 mmHg. This app is available in English, Danish, Portuguese, Russian, and Swedish.
Sponsors: No outside funding was used for creation of this app.
This is an essential, free app for family physicians who have an iOS-compatible device.
APP REVIEW CRITERIA
S – Source or developer of app
P – Platforms available
P – Pertinence to primary care practice
A – Authoritativeness/accuracy/currency of information
C – Cost
E – Ease of use
S – Sponsor(s)
Referencesshow all references
1. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the ACC/AHA task force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889–2934....
2. Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the ACC/AHA task force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2935–2959.
3. American Heart Association. Cardiovascular risk estimator. http://static.heart.org/ahamah/risk/Omnibus_Risk_Estimator.xls. Accessed July 31, 2014.
4. American Academy of Family Physicians. Clinical practice guideline: cholesterol. http://bit.ly/WRLQUA. Accessed July 31, 2014.
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