Atherosclerotic Cardiovascular Disease (ASCVD) risk estimates your 10-year probability of having a heart attack, stroke, or dying from cardiovascular disease. It's the standard risk model used by cardiologists to decide who benefits from statin therapy, blood pressure treatment, and aggressive prevention.

Who is the ASCVD calculator for?

The American College of Cardiology / American Heart Association Pooled Cohort Equations are validated for adults aged 40-79 without known cardiovascular disease. If you've already had a heart attack, stroke, or procedure (stent, bypass), you're automatically considered "high risk" and this calculator doesn't apply — you're already in secondary prevention.

What do the risk categories mean?

ACC/AHA defines: low risk < 5%, borderline 5-7.5%, intermediate 7.5-20%, and high ≥ 20%. Statin therapy is strongly recommended at ≥ 20%, considered at 7.5-20% (especially with other risk factors), and generally not recommended below 5% unless there are additional concerns like family history, elevated Lp(a), or coronary calcium.

Why does the calculator ask about race?

The original 2013 Pooled Cohort Equations were derived from two populations — white and African American — and showed different baseline risks. This has been controversial because "race" isn't biological, and the 2018 equations perform less well in other groups (Asian, Hispanic, etc.). Consider this estimate directional, not exact, for non-white-non-Black users.

What can I do to lower my risk?

The highest-leverage changes: stop smoking (single largest modifiable risk), control blood pressure (target < 130/80), control LDL cholesterol (statins if indicated), manage diabetes if present, stay physically active (150+ minutes/week moderate), and maintain a healthy weight. Diet matters but varies — Mediterranean-style eating is the most-validated.

Is this the most accurate risk model?

For most US adults, yes — it's the model built into every major clinical decision support tool. But newer options exist: PREVENT (2023, AHA) includes kidney function and metabolic factors; QRISK3 (UK) includes more factors. If your risk is borderline, asking for a coronary calcium score (CAC) can dramatically refine the estimate.

ASCVD 10-Year Risk Calculator

Estimate your 10-year risk of heart attack or stroke using the ACC/AHA Pooled Cohort Equations.

Calculator

About the ASCVD Calculator

This is the Pooled Cohort Equations (PCE) risk model, jointly released by the American College of Cardiology and American Heart Association in 2013. It's the standard risk estimator used across US clinical practice to guide prevention decisions — particularly whether to start a statin.

Risk Categories (ACC/AHA 2018)

10-year risk	Category	Typical action
< 5%	Low	Lifestyle only
5 – 7.5%	Borderline	Consider risk enhancers, CAC scan
7.5 – 20%	Intermediate	Moderate-intensity statin recommended
≥ 20%	High	High-intensity statin strongly recommended

Risk Enhancers (Not in the Equation)

For borderline or intermediate results, the ACC lists factors that should push toward more aggressive treatment:

Family history of premature ASCVD (men < 55, women < 65)
LDL-C persistently ≥ 160 mg/dL
Chronic kidney disease (eGFR 15-59)
Metabolic syndrome
Chronic inflammatory conditions (psoriasis, RA, HIV)
Elevated Lp(a) ≥ 50 mg/dL
High-sensitivity CRP ≥ 2.0 mg/L

Coronary Artery Calcium (CAC)

If you land in the borderline-intermediate zone, a CAC scan is often the tiebreaker. A score of 0 can defer statin therapy even at 10-15% risk; a score > 100 moves you into high-risk territory regardless of calculated risk.

Not a Substitute for Medical Evaluation

This tool is for education. Real prevention decisions should involve your clinician, your full labs and history, and shared decision-making about the benefits and side effects of therapy. The equation is also less accurate outside the age 40-79 range or for people already taking statins.

ASCVD 10-Year Risk Calculator

About the ASCVD Calculator

Risk Categories (ACC/AHA 2018)

Risk Enhancers (Not in the Equation)

Coronary Artery Calcium (CAC)

Not a Substitute for Medical Evaluation

Frequently Asked Questions

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