# Reynolds Risk Score

Reynolds Risk Score

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/reynolds`
HTML: https://magentlab.com/docs/reynolds
Markdown: https://magentlab.com/docs/reynolds.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Compute the Ridker JAMA 2007 Reynolds Risk Score 10-year CVD percent for women using clinically simplified Model B (age, SBP, hsCRP, total cholesterol, HDL-C, HbA1c if diabetic, current smoking, and parental MI before age 60).

## When to use

When an agent already has those Model B predictors for a woman aged 45-84 and needs that paper's 10-year CVD percent. Not a diagnosis, statin order, or 2013 pooled-cohort equation.

## When not to use

- Not a medical device. Not a diagnosis of cardiovascular disease. Not a statin order or treatment recommendation.
- Ridker JAMA 2007 Model B for women aged 45 years or older only (magent accepts 45-84). Not the Reynolds algorithm for men (Ridker Circulation 2008).
- Not ATP-III. Not the 2013 ACC/AHA pooled-cohort equations. No race parameter.
- Caller assigns labs, blood pressure, diabetes, smoking, and parental MI before age 60. magent does not assay lipids, hsCRP, or HbA1c and does not measure blood pressure.

## Formula

```
10-year CVD risk (%) = [1 - 0.98634^(exp(B - 22.325))] * 100; B = 0.0799*age + 3.137*ln(SBP) + 0.180*ln(hsCRP) + 1.382*ln(total cholesterol) - 1.172*ln(HDL-C) + 0.134*HbA1c(%) [if diabetic] + 0.818 [if current smoker] + 0.438 [if family history of premature MI]; Ridker JAMA 2007 Model B women; natural log; cholesterol and HDL mg/dL; hsCRP mg/L; SBP mm Hg; not men; not ATP-III; not 2013 PCE
```

## Citation

[Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score](https://doi.org/10.1001/jama.297.6.611)
Ridker PM, Buring JE, Rifai N, Cook NR
JAMA. 2007;297(6):611-619
DOI: [10.1001/jama.297.6.611](https://doi.org/10.1001/jama.297.6.611)

## Worked example

### Age 55, SBP 125, hsCRP 2 mg/L, TC 200, HDL 50, nondiabetic nonsmoker, no family MI

Given: `age=55, diabetes=false, family_mi_before_60=false, hdl_mg_dl=50, hscrp_mg_l=2, sbp_mm_hg=125, smoker=false, total_cholesterol_mg_dl=200`

1. B = 0.0799*55 + 3.137*ln(125) + 0.180*ln(2) + 1.382*ln(200) - 1.172*ln(50) (no A1c, smoker, or family term) = 22.4031
2. 10-year CVD risk (%) = [1 - 0.98634^(exp(B - 22.325))] * 100 = 1.5


### Same labs with diabetes and HbA1c 7.5%

Given: `a1c_percent=7.5, age=55, diabetes=true, family_mi_before_60=false, hdl_mg_dl=50, hscrp_mg_l=2, sbp_mm_hg=125, smoker=false, total_cholesterol_mg_dl=200`

1. Diabetic Model B adds 0.134*7.5 to B
2. b 23.4081; risk_percent 4.0


## Also searched as

- Reynolds Risk Score
- Ridker 2007
- women CVD risk hsCRP
- Reynolds Model B
- 10-year CVD risk women
- parental MI before 60
- hsCRP cholesterol HDL risk

## Parameters

- `age` (integer, required): Age in years (integer 45-84). Ridker JAMA 2007 Model B was derived in women 45 years or older. magent accepts 45-84 only. Not men.
- `sbp_mm_hg` (number, required): Systolic blood pressure in mm Hg (50-250). Enters as ln(SBP). magent does not measure blood pressure.
- `hscrp_mg_l` (number, required): High-sensitivity C-reactive protein in mg/L (0.1-50). Enters as ln(hsCRP). magent does not assay hsCRP.
- `total_cholesterol_mg_dl` (number, required): Total cholesterol in mg/dL (50-800). Enters as ln(total cholesterol). magent does not assay lipids.
- `hdl_mg_dl` (number, required): HDL cholesterol in mg/dL (5-150). Enters as ln(HDL-C). magent does not assay lipids.
- `diabetes` (boolean, required): Diabetes as assigned by the caller. If true, a1c_percent (4-15) is required and adds 0.134*HbA1c(%). If false, omit a1c; the HbA1c term is not added. magent does not diagnose diabetes.
- `a1c_percent` (number, optional): HbA1c in percent (4-15). Required when diabetes=true. Ignored when diabetes=false. magent does not assay HbA1c.
- `smoker` (boolean, required): Current cigarette smoking as assigned by the caller. true adds 0.818. magent does not take a smoking history.
- `family_mi_before_60` (boolean, required): Parental myocardial infarction before age 60 as assigned by the caller. true adds 0.438. magent does not take a family history.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/reynolds`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "age": "55",
      "diabetes": "false",
      "family_mi_before_60": "false",
      "hdl_mg_dl": "50",
      "hscrp_mg_l": "2",
      "sbp_mm_hg": "125",
      "smoker": "false",
      "total_cholesterol_mg_dl": "200"
    },
    {
      "age": "55",
      "diabetes": "false",
      "family_mi_before_60": "false",
      "hdl_mg_dl": "50",
      "hscrp_mg_l": "2",
      "sbp_mm_hg": "125",
      "smoker": "false",
      "total_cholesterol_mg_dl": "200"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/reynolds

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/reynolds",
  "items": [
    {
      "b": 22.4031,
      "age": 55,
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Ridker PM, Buring JE, Rifai N, Cook NR",
        "doi": "10.1001/jama.297.6.611",
        "id": "ridker-2007",
        "pmid": "17299196",
        "source": "JAMA. 2007;297(6):611-619",
        "title": "Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score"
      },
      "formula": "reynolds",
      "formula_expression": "10-year CVD risk (%) = [1 - 0.98634^(exp(B - 22.325))] * 100; B = 0.0799*age + 3.137*ln(SBP) + 0.180*ln(hsCRP) + 1.382*ln(total cholesterol) - 1.172*ln(HDL-C) + 0.134*HbA1c(%) [if diabetic] + 0.818 [if current smoker] + 0.438 [if family history of premature MI]; Ridker JAMA 2007 Model B women; natural log; cholesterol and HDL mg/dL; hsCRP mg/L; SBP mm Hg; not men; not ATP-III; not 2013 PCE",
      "diabetes": false,
      "hdl_mg_dl": 50.0,
      "sbp_mm_hg": 125.0,
      "smoker": false,
      "total_cholesterol_mg_dl": 200.0,
      "family_mi_before_60": false,
      "hscrp_mg_l": 2.0,
      "risk_percent": 1.5
    },
    {
      "b": 22.4031,
      "age": 55,
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Ridker PM, Buring JE, Rifai N, Cook NR",
        "doi": "10.1001/jama.297.6.611",
        "id": "ridker-2007",
        "pmid": "17299196",
        "source": "JAMA. 2007;297(6):611-619",
        "title": "Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score"
      },
      "formula": "reynolds",
      "formula_expression": "10-year CVD risk (%) = [1 - 0.98634^(exp(B - 22.325))] * 100; B = 0.0799*age + 3.137*ln(SBP) + 0.180*ln(hsCRP) + 1.382*ln(total cholesterol) - 1.172*ln(HDL-C) + 0.134*HbA1c(%) [if diabetic] + 0.818 [if current smoker] + 0.438 [if family history of premature MI]; Ridker JAMA 2007 Model B women; natural log; cholesterol and HDL mg/dL; hsCRP mg/L; SBP mm Hg; not men; not ATP-III; not 2013 PCE",
      "diabetes": false,
      "hdl_mg_dl": 50.0,
      "sbp_mm_hg": 125.0,
      "smoker": false,
      "total_cholesterol_mg_dl": 200.0,
      "family_mi_before_60": false,
      "hscrp_mg_l": 2.0,
      "risk_percent": 1.5
    }
  ]
}
```

## Response fields

- `formula` (string): reynolds
- `formula_expression` (string): Ridker JAMA 2007 Model B women Box formula
- `age` (integer): Age in years used (45-84)
- `sbp_mm_hg` (number): Systolic BP used, mm Hg
- `hscrp_mg_l` (number): hsCRP used, mg/L
- `total_cholesterol_mg_dl` (number): Total cholesterol used, mg/dL
- `hdl_mg_dl` (number): HDL-C used, mg/dL
- `diabetes` (boolean): Caller-assigned diabetes used
- `a1c_percent` (number): HbA1c used when diabetes is true. Omitted when diabetes is false.
- `smoker` (boolean): Caller-assigned current smoking used
- `family_mi_before_60` (boolean): Caller-assigned parental MI before age 60 used
- `b` (number): Model B linear predictor B, 4 decimals
- `risk_percent` (number): 10-year CVD risk percent, 1 decimal
- `citation` (object): Ridker et al. JAMA 2007 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "b": 22.4031,
  "age": 55,
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Ridker PM, Buring JE, Rifai N, Cook NR",
    "doi": "10.1001/jama.297.6.611",
    "id": "ridker-2007",
    "pmid": "17299196",
    "source": "JAMA. 2007;297(6):611-619",
    "title": "Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score"
  },
  "formula": "reynolds",
  "formula_expression": "10-year CVD risk (%) = [1 - 0.98634^(exp(B - 22.325))] * 100; B = 0.0799*age + 3.137*ln(SBP) + 0.180*ln(hsCRP) + 1.382*ln(total cholesterol) - 1.172*ln(HDL-C) + 0.134*HbA1c(%) [if diabetic] + 0.818 [if current smoker] + 0.438 [if family history of premature MI]; Ridker JAMA 2007 Model B women; natural log; cholesterol and HDL mg/dL; hsCRP mg/L; SBP mm Hg; not men; not ATP-III; not 2013 PCE",
  "diabetes": false,
  "hdl_mg_dl": 50.0,
  "sbp_mm_hg": 125.0,
  "smoker": false,
  "total_cholesterol_mg_dl": 200.0,
  "family_mi_before_60": false,
  "hscrp_mg_l": 2.0,
  "risk_percent": 1.5
}
```

## Errors

- HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged.
- HTTP 400 `invalid_systolic_bp`: systolic_mm_hg or systolic_bp_mm_hg must be a number from 50 to 250. Returned before settlement; you are not charged.
- HTTP 400 `invalid_crp`: crp_mg_l must be a number from 0 to 500. Returned before settlement; you are not charged.
- HTTP 400 `invalid_medped_lipid`: provide exactly one of total_cholesterol_mg_dl (50-800) or total_cholesterol_mmol_l (1.3-20). Returned before settlement; you are not charged.
- HTTP 400 `invalid_hdl`: hdl_mg_dl must be a number from 5 to 150, or hdl_mmol_l from 0.1 to 3.9, not both. Returned before settlement; you are not charged.
- HTTP 400 `invalid_a1c`: a1c_percent must be a number from 4 to 15 Returned before settlement; you are not charged.
- HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [Framingham CHD](https://magentlab.com/docs/framingham-chd) — Sum Wilson 1998 sex-specific total-cholesterol point sheets (age, TC, HDL, JNC-V blood pressure, diabetes, smoking) and return the published 10-year CHD percent.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.