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.
Score interpretation
→ 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 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 ASCVD Risk (7.5–<20%): moderate-intensity statin therapy recommended after a risk discussion (adults: atorvastatin 10–20 mg, rosuvastatin 5–10 mg); target LDL-C reduction ≥30%. Risk-enhancing factors or a coronary artery calcium score can refine the decision. BP and lifestyle optimisation. Children: use a children's formulary.
→ High ASCVD Risk (≥20%): high-intensity statin therapy recommended (adults: atorvastatin 40–80 mg, rosuvastatin 20–40 mg); target LDL-C ≥50% reduction. Aggressive lifestyle and BP management. Routine aspirin is not recommended for primary prevention (ACC/AHA 2019). Children: use a children's formulary.
Interpretation bands for the ASCVD Risk (Pooled Cohort). Apply clinical judgement and local guidance.
References
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)
- Fluvastatin · HMG-CoA reductase inhibitor (statin)
- Pravastatin sodium · HMG-CoA reductase inhibitor (hydrophilic statin)
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Tenecteplase · 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.