Pooled Cohort Equations for 10-Year ASCVD Risk Estimation
The Pooled Cohort Equations are the guideline-recommended risk calculator to estimate 10-year ASCVD risk in adults aged 40-79 years. 1
Primary Risk Calculator
The race- and sex-specific Pooled Cohort Equations should be used for nonHispanic African Americans and nonHispanic Whites aged 40-79 years 1. These equations provide the most rigorously validated approach for estimating 10-year risk of a first hard ASCVD event, defined as:
- Nonfatal myocardial infarction
- CHD death
- Fatal or nonfatal stroke
Risk Variables Included
The Pooled Cohort Equations incorporate:
- Age
- Total cholesterol
- HDL cholesterol
- Systolic blood pressure (treated or untreated status)
- Diabetes status
- Current smoking status
Implementation Tools
Web-based calculators and downloadable spreadsheets are available at:
- http://my.americanheart.org/cvriskcalculator
- http://www.cardiosource.org/science-and-quality/practice-guidelines-and-quality-standards/2013-prevention-guideline-tools.aspx
Application to Other Populations
For patients from populations other than African Americans and nonHispanic Whites (e.g., Hispanic-Americans, Asian-Americans), the sex-specific Pooled Cohort Equations for nonHispanic Whites may be considered, though this is based on expert opinion rather than validated data 1.
Assessment Frequency
Risk assessment should be repeated every 4-6 years in adults 40-79 years of age who are free from ASCVD and found to be at low 10-year risk (<7.5%) 1.
Important Context: PREVENT Equations
While the 2023 PREVENT equations represent a newer alternative that removes race and adds kidney function variables 2, the Pooled Cohort Equations remain the established guideline-recommended tool from the 2013 ACC/AHA guidelines. The PREVENT equations generally estimate lower risk and would reduce the number of adults meeting criteria for primary prevention statin therapy 2.