(1) PATIENT
yrs
(2) VITALS
mmHg
mmHg
kg/m²
cm
Treated hypertension
(3) LIPIDS
mg/dL
mg/dL
mg/dL
mg/dL
(4) METABOLIC
%
mg/dL
Diabetes mellitus
Current smoker
(5) RENAL
mL/min
mg/g
(6) CLINICAL CONTEXT
Known CVD / ASCVD
Subclinical CVD markers
(a) RISK · 10-YR ASCVD
HIGH RISK44.1%
High risk
<5 LOW7.5 MOD20+ HIGH
AHA CKM
Stage 2
EDMONTON
Class III
BMI 31.2 · Complicated
KDIGO
G3b A2
High risk
(b) KEY DRIVERS
Type 2 diabetes Yes+18.1%
Smoking Yes+12.6%
Systolic BP 152 mmHg+12.2%
Total cholesterol 248 mg/dL+11.2%
(c) NEXT-STEP GUIDANCE
01
Initiate high-intensity statin therapy; consider aspirin if bleeding risk is acceptable.
02
Structured CKM care: target BP <130/80 mmHg, optimize lipids, weight, and glycemic control.
03
Renal protection: consider ACEi/ARB and SGLT2i if appropriate; repeat eGFR and ACR.
04
Obesity-centered intervention: structured weight management with nutrition and activity plan.
05
Start a GLP-1 RA with proven cardiorenal benefit (e.g. semaglutide) alongside an SGLT2 inhibitor for combined cardiac and kidney protection.
ESTIMATION ONLY — NOT A DIAGNOSIS. VERIFY CLINICAL CONTEXT BEFORE ACTION.
(d) GLP-1 / INCRETIN THERAPY
RECOMMENDEDStart a GLP-1 RA with proven cardiorenal benefit (e.g. semaglutide) alongside an SGLT2 inhibitor for combined cardiac and kidney protection.
AGENT
GLP-1 RA with proven CV benefit (semaglutide, dulaglutide, liraglutide)
INDICATION BASIS
Type 2 diabetesHigh 10-yr ASCVD risk (44.1%)CKD (reduced eGFR and/or albuminuria)BMI 31.2 kg/m²
CAUTIONS
- ·Contraindicated with personal/family history of medullary thyroid carcinoma or MEN2.
- ·Titrate slowly; monitor GI tolerance, pancreatitis symptoms, and volume status.
- ·Reduce sulfonylurea/insulin doses to limit hypoglycaemia risk.