Atherosclerosis is a chronic inflammatory disease characterized by the buildup of plaque in the arterial walls. It is a leading cause of heart disease, stroke, and other cardiovascular diseases.

Timely assessment of atherosclerotic risk is crucial for early detection and prevention of these life-threatening conditions. In recent years, researchers have developed indexes and scoring systems to estimate an individual’s atherosclerotic risk.

These indexes take into account various risk factors and provide a comprehensive approach to assessing one’s likelihood of developing atherosclerosis. This article explores some common indexes used to assess atherosclerotic risk and their significance in clinical practice.

1. Framingham Risk Score (FRS)

The Framingham Risk Score is one of the most widely used indexes for assessing cardiovascular risk.

It was developed based on data from the Framingham Heart Study and incorporates age, gender, blood pressure, cholesterol levels, smoking status, and diabetes status. FRS calculates a person’s 10-year risk of developing coronary heart disease and helps guide preventive measures such as lifestyle modifications and medications.

2. Reynolds Risk Score

The Reynolds Risk Score is a newer scoring system that adds two additional risk factors to the Framingham Risk Score: family history of premature heart disease and high-sensitivity C-reactive protein (hsCRP) levels.

By incorporating these additional factors, the Reynolds Risk Score enhances the predictive accuracy of the index, especially for women. It assists clinicians in identifying individuals who may benefit from aggressive risk reduction strategies.

3. SCORE (Systematic COronary Risk Evaluation)

SCORE is a risk scoring system developed by the European Society of Cardiology. It estimates the 10-year risk of fatal cardiovascular disease based on age, gender, smoking status, systolic blood pressure, and total cholesterol.

SCORE provides separate risk charts for individuals with and without diabetes. The index helps identify high-risk individuals who may require more intensive interventions to prevent atherosclerotic events.

4. Ankle-Brachial Index (ABI)

The Ankle-Brachial Index is a simple and non-invasive test used to assess peripheral artery disease (PAD) and indirectly predict atherosclerotic risk. It compares the blood pressure in the ankle to the blood pressure in the arm.

A low ABI suggests significant blockage in the arteries and indicates a higher risk of atherosclerosis in other parts of the body. ABI is an important index for identifying individuals who may benefit from further diagnostic tests and interventions.

5. Coronary Artery Calcium (CAC) Score

The Coronary Artery Calcium Score measures the amount of calcified plaque in the coronary arteries using a specialized computed tomography (CT) scan. This index provides a direct assessment of atherosclerosis in the coronary arteries.

Individuals with a high CAC score have a higher likelihood of experiencing atherosclerotic events. The CAC score helps in risk stratification and decision-making regarding preventive therapies.

6. Atherogenic Index of Plasma (AIP)

The Atherogenic Index of Plasma is a ratio that compares the levels of triglycerides to the levels of high-density lipoprotein (HDL) cholesterol. A higher AIP indicates an increased atherosclerotic risk.

The AIP is a valuable index for individuals with dyslipidemia or metabolic syndrome and aids in tailoring lipid-lowering therapies.

7. Reynolds Risk Score for Men and Women

The Reynolds Risk Score for Men and Women is a gender-specific version of the Reynolds Risk Score. It incorporates additional risk factors such as waist circumference, hemoglobin A1c (HbA1c) levels, and parental history of myocardial infarction.

This index offers a more individualized approach to predicting cardiovascular risk and supports targeted interventions.

8. QRISK

QRISK is a calculator developed in the United Kingdom that estimates an individual’s 10-year risk of developing cardiovascular disease.

It takes into account various risk factors, including age, sex, ethnicity, smoking status, blood pressure, cholesterol levels, family history, and diabetes status. QRISK considers a wide range of factors to provide a more comprehensive assessment of atherosclerotic risk in a diverse population.

9. Metabolic Syndrome Z-Score

The Metabolic Syndrome Z-Score is an index that combines the components of metabolic syndrome, such as central obesity, high blood pressure, elevated triglycerides, low HDL cholesterol, and impaired fasting glucose.

This index helps identify individuals with metabolic syndrome who are at increased risk of atherosclerosis and guides management strategies targeting metabolic abnormalities.

10. Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator Plus

The ASCVD Risk Estimator Plus is a tool developed by the American College of Cardiology and the American Heart Association. It estimates the 10-year risk of a first atherosclerotic cardiovascular disease event, including heart attack and stroke.

The calculator incorporates multiple risk factors, including age, race, cholesterol levels, blood pressure, diabetes status, and smoking history. The ASCVD Risk Estimator Plus helps guide risk-based treatment decisions and supports shared decision-making between healthcare providers and patients.