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The following question refers to Section 3.2 of the 2021 ESC CV Prevention Guidelines.\xa0The question is asked by CardioNerds Academy Intern, student Dr.\xa0Hirsh Elhence, answered first by Ohio State University Cardiology Fellow\xa0Dr. Alli Bigeh, and then by expert faculty\xa0Dr. Eugene Yang.\n\nDr. Yang is professor of medicine of the University of Washington where he is medical director of the Eastside Specialty Center and the co-Director of the Cardiovascular Wellness and Prevention Program. Dr. Yang is former Governor of the ACC Washington Chapter and current chair of the ACC Prevention of CVD Section.\xa0\n\nThe CardioNerds Decipher The Guidelines Series for the 2021 ESC CV Prevention Guidelines\xa0represents a collaboration with the\xa0ACC Prevention of CVD Section, the\xa0National Lipid Association, and\xa0Preventive Cardiovascular Nurses Association.\n\nQuestion #19\n\n\n\nTrue or False: A 70-year-old male has an estimated 10-year ASCVD risk (using SCORE2-OP) of 7.5% which confers a very high CVD risk and necessitates treatment with a statin.\xa0\n\n\nTRUE\xa0\n\n\nFALSE\xa0\n\n\n\nAnswer #19\n\n\n\nExplanation\xa0\xa0\nFALSE \u2013 CVD risk thresholds for risk factor treatment are higher in apparently healthy people 70 years and older in order to prevent overtreatment in the elderly. A 10-year CVD risk \u226515% is considered \u201cvery high risk\u201d for individuals \u226570 years of age (compared to a \u22657.5% cut-off for \u201cvery high risk\u201d in younger patients <50 years old). For these patients, treatment of ASCVD risk factors, including lipid-lowering medications, is recommended (class IIb).\xa0 Lifetime benefit of treatment in terms of time gained free of CVD is lower in older people. The SCORE2-OP algorithm estimates 5-year and 10-year fatal and non-fatal CVD events adjusted for competing risks of non-CVD mortality. Treatment and risk stratification should (as with all patients) be individualized.\xa0\xa0\n\nFor patient >70 years of age, a 10-year CVD risk of 7.5 to <15% is considered \u201chigh risk\u201d, and treatment of risk factors should be considered taking CVD risk modifiers, frailty, lifetime treatment benefit, comorbidities, polypharmacy, and patient preference into account.\xa0\xa0\n\nFor patient >70 years of age, a 10-year CVD risk of <7.5 is considered \u201clow-to-moderate risk\u201d and would generally not qualify for risk factor treatment unless one or several risk modifiers are present.\xa0\xa0\n\nSmoking cessation, lifestyle recommendations and a SBP <160 mmHg are recommended for all.\xa0\n\n\nMain Takeaway\xa0\n\n\n \tCVD risk assessment for patients 70-years and older is estimated using the SCORE2-OP algorithm. A predicted 10-year CVD risk score of \u226515% confers a very high CVD risk, however, this it is a class IIb indication to initiate/intensify lipid lowering therapies in these patients. Decision should be individualized and based on benefits vs risk assessment.\xa0\n\n\n\n\nGuideline Loc.\xa0\n\n\n \t3.2.3.5\xa0\n\n\n\n\n\nCardioNerds Decipher the Guidelines - 2021 ESC Prevention Series\nCardioNerds Episode Page\nCardioNerds Academy\nCardionerds Healy Honor Roll\n\nCardioNerds Journal Club\nSubscribe to The Heartbeat Newsletter!\nCheck out CardioNerds SWAG!\nBecome a CardioNerds Patron!