EBMcalc Logo
   INTRO    EQUATIONS    CRITERIA    DECISION    CONVERT    SPECIALTIES    REFS    SEARCH    NEW    FHIR APP    CONTACT
 
  Cardiovascular Risk Assessment (10-year, ACC/AHA PCE: Pooled Cohort Equations)

 
Input
 
Race American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White
Sex Female

Male
Age  
Total Cholesterol  
HDL Cholesterol  
Systolic Blood Pressure  
On Hypertension Med No

Yes
Diabetes No

Yes
Smoker No

Yes

 
Results
 
Important: Inputs must be complete to perform calculation.

 
 
ACC AHA 10 Yr Risk  
 
Decimal Precision  

 
     
 
Include literature references: Yes   No
 

 

 
Notes
  • This calculator helps predict the 10-year risk of the following hard ASCVD events:
    • First occurrence of nonfatal myocardial infarction
    • CHD death
    • Fatal or nonfatal stroke
  • This calculator may overestimate risk (see Lancet reference) and a discussion with the patient needs to ensue if there are any questions.
  • Risk estimates were developed from cohorts primarily comprising White and African American subjects. Risk may be underestimated in American Indians, Asian Americans of South Asian ancestry, and Puerto Ricans. Risk may be overestimated in Asian Americans of East Asian ancestry and some Mexican Americans.

 
Equations used
 
Terms = (CAge * ln(Age)) + (CSqAge * ln(Age)2) + (CTotalChol * ln(TotalCholesterol)) + (CAgeTotalChol * ln(Age) * ln(TotalCholesterol)) + (CHDLChol * ln(HDLCholesterol)) + (CAgeHDLChol * ln(Age) * ln(HDLCholesterol)) + (OnHypertensionMed * COnHypertensionMeds * ln(SystolicBloodPressure)) + (OnHypertensionMed * CAgeOnHypertensionMeds * ln(Age) * ln(SystolicBloodPressure)) + (!OnHypertensionMed * COffHypertensionMeds * ln(SystolicBloodPressure)) + (!OnHypertensionMed * CAgeOffHypertensionMeds * ln(Age) * ln(SystolicBloodPressure)) + (CSmoker * Smoker) + (CAgeSmoker * ln(Age) * Smoker) + (CDiabetes * Diabetes)
ACCAHA10YrRisk = 100 * (1 - S10e(Terms-MeanTerms))

 

 
Calculation Details and Variables
  • For Black or African American female patients CAge = 17.114; CSqAge = 0; CTotalChol = 0.94; CAgeTotalChol = 0; CHDLChol = -18.92; CAgeHDLChol = 4.475; COnHypertensionMeds = 29.291; CAgeOnHypertensionMeds = -6.432; COffHypertensionMeds = 27.82; CAgeOffHypertensionMeds = -6.087; CSmoker = 0.691; CAgeSmoker = 0; CDiabetes = 0.874; S10 = 0.9533; MeanTerms = 86.61.
  • For White or other race female patients CAge = -29.799; CSqAge = 4.884; CTotalChol = 13.54; CAgeTotalChol = -3.114; CHDLChol = -13.578; CAgeHDLChol = 3.149; COnHypertensionMeds = 2.019; CAgeOnHypertensionMeds = 0; COffHypertensionMeds = 1.957; CAgeOffHypertensionMeds = 0; CSmoker = 7.574; CAgeSmoker = -1.665; CDiabetes = 0.661; S10 = 0.9665; MeanTerms = -29.18.
  • For Black or African American male patients CAge = 2.469; CSqAge = 0; CTotalChol = 0.302; CAgeTotalChol = 0; CHDLChol = -0.307; CAgeHDLChol = 0; COnHypertensionMeds = 1.916; CAgeOnHypertensionMeds = 0; COffHypertensionMeds = 1.809; CAgeOffHypertensionMeds = 0; CSmoker = 0.549; CAgeSmoker = 0; CDiabetes = 0.645; S10 = 0.8954; MeanTerms = 19.54.
  • For White or other race male patients CAge = 12.344; CSqAge = 0; CTotalChol = 11.853; CAgeTotalChol = -2.664; CHDLChol = -7.99; CAgeHDLChol = 1.769; COnHypertensionMeds = 1.797; CAgeOnHypertensionMeds = 0; COffHypertensionMeds = 1.764; CAgeOffHypertensionMeds = 0; CSmoker = 7.837; CAgeSmoker = -1.795; CDiabetes = 0.658; S10 = 0.9144; MeanTerms = 61.18.

 
References
  1. Goff DC Jr, Lloyd-Jones DM, Bennett G, et.al. 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. Circulation. 2013 Nov 12. PubMed ID: 24222018 PubMed Logo
  2. Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013 Nov 12. PubMed ID: 24222016 PubMed Logo
  3. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013 Nov 30;382(9907):1762-5. doi: 10.1016/S0140-6736(13)62388-0. Epub 2013 Nov 20. PubMed ID: 24268611 PubMed Logo
  4. Downs J, Good C. New Cholesterol Guidelines: Has Godot Finally Arrived? Ann Intern Med. 2014 Jan 28. doi: 10.7326/M13-2850. PubMed ID: 24473934 PubMed Logo
  5. Vaishnava P, Eagle KA. ACP Journal Club. ACC/AHA, Adult Treatment Panel III, and ESC guidelines overestimated risk for CVD in older adults. Ann Intern Med. 2014 Aug 19;161(4):JC13. PubMed ID: 25133380 PubMed Logo
  6. Kavousi M, Leening MJ, Nanchen D, et al. Comparison of Application of the ACC/AHA Guidelines, Adult Treatment Panel III Guidelines, and European Society of Cardiology Guidelines for Cardiovascular Disease Prevention in a European Cohort. JAMA. 2014 Mar 29. doi: 10.1001/jama.2014.2632. PubMed ID: 24681960 PubMed Logo
  7. Navar-Boggan AM, Newby LK. ACC/AHA Pooled Cohort Risk Equations predicted 5-y risk for CV events in adults considered for statin initiation. Ann Intern Med. 2014 Aug 19;161(4):JC12. PubMed ID: 25133379 PubMed Logo
  8. Muntner P, Colantonio LD, Cushman M, et al. Validation of the Atherosclerotic Cardiovascular Disease Pooled Cohort Risk Equations. JAMA. 2014 Mar 29. doi: 10.1001/jama.2014.2630. PubMed ID: 24682252 PubMed Logo
  9. DeFilippis AP, Young R, Carrubba CJ, et al. An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort. Ann Intern Med. 2015 Feb 17;162(4):266-75. PubMed ID: 25686167 PubMed Logo
  10. Ridker PM, Cook NR. Comparing cardiovascular risk prediction scores. Ann Intern Med. 2015 Feb 17;162(4):313-4. PubMed ID: 25686171 PubMed Logo
  11. Pursnani A, Massaro JM, D'Agostino RB Sr, et al. Guideline-Based Statin Eligibility, Coronary Artery Calcification, and Cardiovascular Events. JAMA. 2015 Jul 14;314(2):134-41. PubMed ID: 26172893 PubMed Logo
  12. US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016 Nov 15;316(19):1997-2007. PubMed ID: 27838723 PubMed Logo
  13. Arnett DK, Blumenthal RS, Albert MA, et al. 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. Circulation. 2019 Sep 10;140(11):e596-e646. PubMed ID: 30879355 PubMed Logo
  14. Vasan RS, van den Heuvel E. Differences in estimates for 10-year risk of cardiovascular disease in Black versus White individuals with identical risk factor profiles using pooled cohort equations: an in silico cohort study. Lancet Digit Health. 2022 Jan;4(1):e55-e63. PubMed ID: 34952676 PubMed Logo

 

 
Associated Logical Observation Identifiers Names and Codes [LOINC]
 
Parameter LOINC's and Suggested Units
Age 21612-7 : yr      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years      
Total Cholesterol 2093-3 : mg/dL      14647-2 : mmol/L      
HDL Cholesterol 2085-9 : mg/dL      14646-4 : mmol/L      
Systolic Blood Pressure 8480-6 : mmHg      
ACC AHA 10 Yr Risk 79423-0 : %      

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

 
Associated ICD10-CM Codes
 
   I25.84Coronary atherosclerosis due to calcified coronary lesion
   E78.5Hyperlipidemia, unspecified
   E78.4Other hyperlipidemia
   E78.2Mixed hyperlipidemia
   I10Essential (primary) hypertension
   I67.2Cerebral atherosclerosis

 
Associated ICD9-CM Codes
 
   434.0Cerebral thrombosis
   437.0Cerebral atherosclerosis
   401Essential hypertension
   401.1Benign hypertension
   272.2Mixed hyperlipidemia
   272.4Hyperlipidemia nec/nos
   414.0Coronary atherosclerosis
   414.4Coronary atherosclerosis

 

 
Legal Notices and Disclaimer

 
All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer.
 
EBMcalc is Copyright © 1998-2023 Foundation Internet    [Build 271986 v23.4]