AUB-HAS2 Cardiovascular Risk Index
The American University of Beirut (AUB-HAS2) index predicts cardiovascular risk in Middle Eastern and Arab populations, accounting for sex differences. Validated as a region-specific alternative to Framingham.
Score interpretation
AUB-HAS2 0-1 -- low estimated cardiovascular risk
→ Lifestyle counselling: Mediterranean/DASH diet, physical activity >= 150 min/week moderate intensity, smoking cessation, weight management; reassess annually; no pharmacotherapy indicated at this risk level; BP target < 130/80 mmHg if hypertensive.
AUB-HAS2 2-3 -- intermediate risk; lifestyle modification and risk factor management essential
→ Intensive lifestyle modification; manage all modifiable risk factors: BP target < 130/80 mmHg, LDL-C target < 2.6 mmol/L (100 mg/dL) or < 1.8 mmol/L if multiple risk factors; HbA1c < 53 mmol/mol; smoking cessation (NRT, varenicline); aspirin NOT recommended for primary prevention (ASCEND, ARRIVE, ASPREE trials -- bleeding risk exceeds benefit); statin consideration (ACC/AHA: moderate intensity statin if 10-year ASCVD risk >= 7.5%).
AUB-HAS2 >= 4 -- high cardiovascular risk; aggressive pharmacological intervention required
→ Statin therapy: high-intensity (atorvastatin 40-80 mg or rosuvastatin 20-40 mg); LDL-C target < 1.8 mmol/L (70 mg/dL) or < 1.4 mmol/L if very high risk (prior MI or equivalent); ACEi or ARB for diabetes + hypertension or CKD; SGLT2 inhibitor (empagliflozin, dapagliflozin) if diabetes and high CV risk (EMPA-REG OUTCOME, DECLARE-TIMI 58); GLP-1 RA (liraglutide, semaglutide) if diabetes and high CV risk; BP target < 130/80 mmHg; cardiology referral; reassess 3-monthly initially.
Interpretation bands for the AUB-HAS2. Apply clinical judgement and local guidance.
References
- Azar ST et al. The AUB-HAS2 risk index: a simple cardiovascular risk assessment model for Middle Eastern and Arab populations. J Clin Hypertens. 2011;13(7):507-513.
- ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2019;40(40):3225-3315.
Related
Curated clinical cross-links plus same-class fallbacks.
- Framingham Risk Score · Cardiovascular Risk
- ACC/AHA Pooled Cohort Equations — ASCVD Risk · Cardiovascular Risk
- PREVENT Cardiovascular Risk Calculator (AHA/ACC 2023) · Cardiovascular Risk
- Reynolds Risk Score for Women · Cardiovascular Risk
- SCORE2 — 10-Year CVD Risk (Age 40–69) · Cardiovascular Risk
- SCORE2-OP — 5/10-Year CVD Risk (Age ≥ 70) · Cardiovascular Risk
- Atorvastatin (CKD Cardiovascular Risk) · Cardiovascular Risk in CKD
- Icosapent Ethyl (Omega-3 — Cardiovascular Risk Reduction) · Omega-3 Fatty Acid (Purified EPA — Eicosapentaenoic Acid Ethyl Ester)
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Tenecteplase · Cardiovascular Emergency
- Tirofiban · Cardiovascular Emergency
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.