Step 4: 10-Year Risk

There are three levels of 10-year risk. The presence of CHD or CHD risk equivalent automatically places a patient in the greater than 20% risk category.

First count the number of risk factors (excluding LDL and CHD) present. If the patient
has 2 or more risk factors then the Framingham scoring system should be used
to determine the level of risk and intensity of therapy. (Online risk calculator).

Framingham scoring is not warranted for patients with 1 or fewer risk factors. The 10-year
risk in these individuals typically does not require intensive therapy. However, if the patient
has a very high LDL, then intensive drug therapy may be considered for long-term prevention.

Three levels of 10-year risk:

>20% -- CHD risk equivalent

10-20% (2 or more risk factors)

<10% (0 to 1 risk factors)