Interpretation
| Result | Meaning |
|---|---|
| < 5% | Low |
| 5–7.4% | Borderline |
| 7.5–19.9% | Intermediate |
| ≥ 20% | High |
Formula
10-yr risk = 1 − S₁₀^exp(Σβx − mean), sex- and race-specific coefficients on ln(age), ln(TC), ln(HDL), ln(SBP, treated or untreated), smoking, diabetes and interactions (Goff 2013). Baseline S₁₀ / mean: white women 0.9665 / −29.18; African American women 0.9533 / 86.61; white men 0.9144 / 61.18; African American men 0.8954 / 19.54.
Clinical pearls
- Valid only for age 40–79, TC 130–320 mg/dL, HDL 20–100 mg/dL, SBP 90–200 mmHg, and no known ASCVD; LDL ≥190 or diabetes age 40–75 already warrant statins regardless.
- Overestimates risk in many contemporary and Asian/Hispanic populations; the AHA PREVENT equations (2023) are a race-free successor.
- Use risk-enhancing factors (family history, Lp(a), CKD, CAC score) to refine borderline/intermediate decisions.
Examples
ascvd risk 55M white tc 213 hdl 50 sbp 120 untreated nonsmoker no dm10 year cardiovascular risk for a 62 year old black woman, total cholesterol 5.2 mmol/L, HDL 1.3, BP 140 on treatment, diabeticpooled cohort equations 48F smoker chol 220 hdl 45 sbp 130
FAQ
What ASCVD risk warrants a statin?
For adults 40–75 with LDL 70–189 mg/dL, a 10-year risk ≥7.5% favours a moderate-intensity statin after a risk discussion; ≥20% favours high intensity. 5–7.4% is borderline.
What should I use for races other than white or African American?
The guideline recommends the white equations for other groups, recognizing they may over- or underestimate risk.