American College of Cardiology and the American Heart Association guideline recommendations2,3 include:
- Estimate 10-year risk for atherosclerotic cardiovascular disease (ASCVD)2
- Due to inherent limitations of risk estimation tools in individual patients, consider the risk-enhancing factors below, which align with those set forth in the 2019 ACC/ACOG Advisory, for adults 40 to 75 years with borderline- (5% to < 7.5%) or intermediate- (≥ 7.5% to < 20%) risk2
- History of premature menopause (< 40 years) and history of pregnancy-associated conditions that increase later risk, including:2,3
- Pre-eclampsia
- Eclampsia
- Gestational hypertension
- Gestational diabetes
- Pre-term delivery
- Low birthweight for gestational age
- Polycystic ovary disease
- Functional hypothalamic amenorrhea
- Reproductive hormones including oral contraceptives and hormone replacement3
- Breast cancer3
- Chronic inflammatory conditions such as rheumatoid arthritis, lupus, and scleroderma2
- Family history of premature ASCVD (< 65 years)2
- Primary hypercholesterolemia (LDL-C, 160-189 mg/dL; non-HDL-C, 190-219 mg/dL)*2
- Metabolic syndrome - a total of 3 of the following is diagnostic2
- Increased waist circumference (by ethnically appropriate cutpoints);
- Elevated triglycerides (≥150 mg/dL, non-fasting)
- Low HDL-C (< 50 mg/dL)
- Elevated glucose
- Elevated blood pressure
- Chronic kidney disease (eGFR 15-59 mL/min/1.73 m2 with or without albuminuria; not treated with dialysis or kidney transplantation}2
- High risk race or ethnicity (e.g. South Asian ancestry)2
- Lipids and biomarkers (associated with increased ASCVD risk)2
- Persistently elevated triglycerides (≥ 175 mg/dL, non-fasting)
- Elevated high-sensitivity C-reactive protein (≥ 2.0 mg/L)
- Elevated Lipoprotein(a) – ≥ 125 nmol/L constitutes risk-enhancing factor; relative indication for measurement is family history of premature ASCVD
- Elevated Apolipoprotein B (≥ 130 mg/dL, corresponding to LDL-C > 160 mg/dL) constitutes risk-enhancing factor; relative indication for measurement is triglyceride ≥ 200 mg/dL (≥ 130 mg/dL)
Women with a medical history of pre-eclampsia who gave birth preterm (less than 37 0/7 weeks of gestation) or who have a medical history of recurrent preeclampsia, are recommended by ACOG to have a yearly assessment of blood pressure, lipids, fasting blood glucose, and body mass index.4
Labcorp offers a wide range of cardiovascular testing options.