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cardiology general-medicine

ACC/AHA Pooled Cohort Equations (ASCVD Risk)

2013 ACC/AHA Pooled Cohort Equations. Estimates 10-year risk of first atherosclerotic cardiovascular disease (ASCVD) event. Guides statin therapy initiation per ACC/AHA guidelines.

Used in: Hypertension

Score interpretation

Low Risk (<5% 10-year ASCVD)

→ Low ASCVD Risk (<5%): Lifestyle modification emphasis (diet, exercise, smoking cessation). Statin not routinely indicated unless LDL-C >190 mg/dL or diabetes. Reassess in 4–6 years.

Borderline Risk (5–7.4%)

→ Borderline ASCVD Risk (5–7.5%): Risk-enhancing factors may favour statin therapy. Discuss with patient; consider moderate-intensity statin if LDL-C ≥70 mg/dL with risk-enhancing factors (CRP, Lp(a), ABI <0.9, CAC score).

Intermediate Risk (7.5–10%)

→ Intermediate ASCVD Risk (7.5–10%): Moderate-intensity statin therapy recommended (atorvastatin 10–20 mg, rosuvastatin 5–10 mg). Target LDL-C reduction ≥30%. BP and lifestyle optimisation.

High Risk (≥10% 10-year ASCVD)

→ High ASCVD Risk (≥10%): High-intensity statin therapy recommended (atorvastatin 40–80 mg, rosuvastatin 20–40 mg). Target LDL-C ≥50% reduction. Aspirin 75–100 mg if not contraindicated. Aggressive lifestyle modification.

Interpretation bands for the ASCVD Risk (Pooled Cohort). Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.