ACC/AHA Pooled Cohort Equations
2013 ACC/AHA Pooled Cohort Equations for ASCVD
#12
coverage rank
United States201310-yearHard ASCVD (nonfatal MI, CHD death, fatal/nonfatal stroke)9 inputs
Adults 40-79, non-Hispanic White & African-American, no ASCVD
8
atlas factors covered
7
strongly-evidenced (A/B)
5
of 15 categories
Strengths
- First guideline-endorsed race- and sex-specific US equations; simple, widely implemented
- Predicts hard ASCVD (MI, stroke) with 10-year horizon aligned to statin decisions
Weaknesses
- Overestimates risk in contemporary and higher-SES cohorts
- Uses a binary Black/White race variable now considered scientifically problematic
- Only 9 inputs; omits triglycerides, family history, CKD, inflammation, obesity, Lp(a)
- Derived from older cohorts; poor transportability outside US non-Hispanic White/Black groups
Input variables (9)
| Input | Maps to atlas factor | Category | Grade | Note |
|---|---|---|---|---|
| Age | Age | Demographic & Social | A | |
| Sex | Sex | Demographic & Social | C | |
| Race (White vs African-American) | Race/ethnicity | Demographic & Social | A | |
| Total cholesterol | Total cholesterol | Lipids & Lipoproteins | A | |
| HDL cholesterol | HDL cholesterol | Lipids & Lipoproteins | A | |
| Systolic blood pressure | Systolic blood pressure | Blood Pressure & Hemodynamics | A | |
| Treatment for hypertension | — derived / not in atlas | — | — | treatment/medication-use variable; not a factor in atlas |
| Diabetes mellitus | Type 2 diabetes mellitus | Glycemic & Metabolic | A | |
| Current smoking | Cigarette smoking | Lifestyle & Behavioral | A |
References
- 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk — Circulation 2014 · PMID 24222018
- A systematic examination of the 2013 ACC/AHA pooled cohort risk assessment tool for ASCVD — J Am Coll Cardiol 2014 · PMID 25190228