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September 6, 2026Journal of the American College of CardiologyOpen Access

2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk

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Authors

BABruce W. AndrusDLDiane Lacaille

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Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

DMDonald M. Lloyd-JonesChair of Preventive Medicine, Northwestern University

“Cardiovascular disease caused by atherosclerosis remains the number one cause of death, a major cause of disability and a huge source of health care costs. We must do a better job of preventing it. That means being smarter in our approach to determine who should get medications, for example.”

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RSRoger S. BlumenthalCardiologist, Johns Hopkins University

“It is a major step forward that the guidelines now assess risk for both heart attacks and strokes. Well-meaning experts in the field of cardiovascular prevention will disagree on some of the fine points, and this guideline is meant to inform clinical judgment rather than replace it.”

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DCDavid C. Goff Jr.Dean and Professor, Colorado School of Public Health

“The vast majority of heart attacks and strokes could be prevented if people knew their risk and did the things we know are effective in reducing that risk, but patients and doctors alike often underestimate cardiovascular disease risk, especially when considered over the lifespan. This document offers clinicians the most up-to-date, comprehensive guidance about assessing that risk, so they can work with their patients to prevent heart attack and stroke.”

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Overview

Clinical guideline outlines 10-year atherosclerotic risk estimation in adults, highlighting pooled cohort equations to guide preventive therapies.

Key Points

  • To provide evidence-based recommendations and risk estimation tools for evaluating 10-year and lifetime atherosclerotic cardiovascular disease (ASCVD) risk to inform primary prevention strategies.
  • Systematic evidence review of risk assessment algorithms across diverse epidemiological cohorts.
  • Development and derivation of sex- and race-specific Pooled Cohort Equations to estimate 10-year first-occurrence ASCVD risk.
  • Establishes the Pooled Cohort Equations as the recommended primary assessment tool for non-Hispanic white and African American adults aged 40 to 79 years without preexisting ASCVD.
  • Identifies a 10-year ASCVD risk threshold of ≥7.5% as the primary decision point to discuss and initiate moderate-to-high-intensity statin therapy alongside lifestyle interventions.

Cite This Study

Andrus et al. (2014) studied this question.

synapsesocial.com/papers/6a9cdb973cc8da7d0c4d627fhttps://doi.org/10.1016/j.jacc.2014.02.606
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