Curated insights • How it Works • Practical Pearls • Evidence Base
Validated for adults aged 40–79 years without pre-existing clinical ASCVD (e.g., prior MI, stroke, PAD).
| Demographics |
| Lipids |
| Blood Pressure |
| Comorbidities |
| Behaviors |
| Low Risk |
| Borderline Risk |
| Intermediate Risk |
| High Risk |
The Pooled Cohort Equations (PCE) utilize a sex- and race-specific Cox proportional hazards model. Unlike the older Framingham score, the PCE specifically includes stroke as an endpoint and accounts for the higher baseline risk observed in African American populations.
In Intermediate Risk (7.5–19.9%) or Borderline Risk (5–7.4%) cases where the treatment decision is unclear, a Coronary Artery Calcium (CAC) score can reclassify risk. CAC = 0 (low risk, consider delaying statin); CAC 1–99 (favors statin); CAC ≥ 100 or ≥ 75th percentile (statin indicated).
Adults aged 40–75 with Diabetes Mellitus and LDL-C 70–189 mg/dL should be started on at least a moderate-intensity statin regardless of the 10-year ASCVD score. If score is ≥ 7.5%, consider high-intensity.
2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
The PCE was a response to the limitation of the Framingham Heart Study, which was primarily composed of White participants. By pooling data from the Framingham, ARIC, CARDIA, and CHS studies, the ACC/AHA created a tool that better reflected the diverse demographics of the modern United States.
ASCVD Risk: Estimates 10-year risk of atherosclerotic cardiovascular events (ACC/AHA 2013).
Curated insights • How it Works • Practical Pearls • Evidence Base
Validated for adults aged 40–79 years without pre-existing clinical ASCVD (e.g., prior MI, stroke, PAD).
| Demographics |
| Lipids |
| Blood Pressure |
| Comorbidities |
| Behaviors |
| Low Risk |
| Borderline Risk |
| Intermediate Risk |
| High Risk |
The Pooled Cohort Equations (PCE) utilize a sex- and race-specific Cox proportional hazards model. Unlike the older Framingham score, the PCE specifically includes stroke as an endpoint and accounts for the higher baseline risk observed in African American populations.
In Intermediate Risk (7.5–19.9%) or Borderline Risk (5–7.4%) cases where the treatment decision is unclear, a Coronary Artery Calcium (CAC) score can reclassify risk. CAC = 0 (low risk, consider delaying statin); CAC 1–99 (favors statin); CAC ≥ 100 or ≥ 75th percentile (statin indicated).
Adults aged 40–75 with Diabetes Mellitus and LDL-C 70–189 mg/dL should be started on at least a moderate-intensity statin regardless of the 10-year ASCVD score. If score is ≥ 7.5%, consider high-intensity.
2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
The PCE was a response to the limitation of the Framingham Heart Study, which was primarily composed of White participants. By pooling data from the Framingham, ARIC, CARDIA, and CHS studies, the ACC/AHA created a tool that better reflected the diverse demographics of the modern United States.
