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Cardiology Equation Moderate evidence Clinical review pending v1.0.0

ASCVD 10-Year Risk — Pooled Cohort Equations (2013)

What is the 10-year risk of a first atherosclerotic cardiovascular event to guide statin therapy?

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Demographics

Sex

Female Male

Race (as used by the equations) The PCE were derived only for African American and non-Hispanic white adults. The white equations are used for other groups and may misestimate risk.

White or other African American

Age

years

Valid for ages 40–79 years.

Measurements

Total cholesterol

Valid range 130–320 mg/dL (3.4–8.3 mmol/L).

HDL cholesterol

Valid range 20–100 mg/dL (0.5–2.6 mmol/L).

Systolic blood pressure

mmHg

History

Currently treated for hypertension

Diabetes

Current smoker

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About this tool

The 2013 ACC/AHA sex- and race-specific equations estimating 10-year risk of a first hard ASCVD event in adults 40–79 without ASCVD, with a current-versus-optimal risk comparison.

Intended use

Primary prevention in adults aged 40–79 without clinical ASCVD.

Outcome

First hard ASCVD event (nonfatal MI, CHD death, fatal/nonfatal stroke)

Time horizon

10 years

Derivation population

Pooled US community cohorts (ARIC, CHS, CARDIA, Framingham Original and Offspring).

Do not use in

Established ASCVD, LDL-C ≥ 190 mg/dL, age outside 40–79.

Limitations

Overestimates risk in many contemporary and higher-socioeconomic populations.
Derived only in non-Hispanic white and African American adults.
Does not include kidney function, social deprivation or family history.

Clinical problems

Cardiovascular prevention

Evidence

Evidence level

Moderate evidence

Widely validated and guideline-endorsed, but with documented miscalibration (overestimation) in contemporary cohorts. Methodology

Guideline status

Basis of the 2018 ACC/AHA cholesterol and 2019 ACC/AHA primary-prevention guidelines.

Calibration

Overestimation reported in several contemporary US cohorts.

Geographic applicability

United States populations.

Demographic applicability

Non-Hispanic white and African American adults; other groups use the white equations.

Evidence summaries for this tool are awaiting independent clinical review. Statistics are shown only where they could be attributed to a specific publication.

References

Original publicationGoff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Circulation 2014;129(25 Suppl 2):S49-S73. Find on PubMed (opens in a new tab)
GuidelineGrundy SM, Stone NJ, et al. 2018 AHA/ACC Guideline on the Management of Blood Cholesterol. Circulation 2019;139:e1082-e1143. Find on PubMed (opens in a new tab)
GuidelineArnett DK, Blumenthal RS, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Circulation 2019;140:e596-e646. Find on PubMed (opens in a new tab)

Version history

Version	Formula	Effective	Reviewer	Changes
v1.0.0	Goff 2013 Table A coefficients	2026-10-03	—	Initial implementation with reference test vectors.

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Clinical decision support only. Interpret results in the context of the individual patient and current guidance; HumanPulse does not replace professional medical judgment.