About the ASCVD Risk Calculator
This ASCVD risk calculator estimates the chance of a first heart attack, coronary death or stroke within the next 10 years using the 2013 ACC/AHA Pooled Cohort Equations — the same equations US clinicians use to guide statin and blood-pressure decisions. It needs your age, sex, race, total and HDL cholesterol, systolic blood pressure, and whether you are treated for high blood pressure, have diabetes or smoke.
It is designed for adults aged 40–79 without existing cardiovascular disease who want to understand a number their doctor may quote, or see how quitting smoking or lowering blood pressure would change it. Alongside your risk the calculator shows the risk of a person the same age and sex with optimal risk factors, and a what-if table for common changes.
The equations were derived from US cohorts and may over- or under-estimate risk in some populations; they do not apply if you already have heart disease or an LDL of 190 mg/dL or more. Separate equations exist for African American adults; other groups use the white equations.
With the default inputs, the 10-year ascvd risk is 5.4%. Change any value above to recalculate instantly.
How to use the ascvd risk calculator
- 1Select sex and race, then enter your age (40–79).
- 2Enter total and HDL cholesterol from a recent blood test, choosing mg/dL or mmol/L.
- 3Enter your systolic (top) blood pressure and whether you take blood pressure medication.
- 4Switch on diabetes and smoking if they apply.
- 5Read your 10-year risk and category, then check the what-if table.
Formula and method
The Pooled Cohort Equations are Cox proportional-hazards models fitted separately for white women, African American women, white men and African American men. Each takes natural logs of age, total cholesterol, HDL and systolic blood pressure (with different coefficients for treated and untreated pressure), plus indicators for smoking and diabetes and some interaction terms, and sums them into an individual score Σβx.
That score is compared with the cohort mean and plugged into the baseline 10-year survival S₀ (0.9665, 0.9533, 0.9144 and 0.8954 for the four groups) to give a probability. The 2018 cholesterol guideline groups results as low (<5%), borderline (5–7.4%), intermediate (7.5–19.9%) and high (≥20%). Inputs are capped to the validated ranges.
- S₀
- Baseline 10-year survival for the sex/race group
- Σβx
- Sum of coefficients × ln(age, TC, HDL, SBP) and risk-factor indicators
- mean
- Mean of Σβx in the derivation cohort
Worked examples
Guideline reference: white man, 55
With total cholesterol 213, HDL 50 and an untreated systolic pressure of 120, a 55-year-old white non-smoking man without diabetes has a 10-year risk of about 5.4% — the reference value published with the guideline (5.3%).
Same profile, African American woman
Using the African American women’s equation with the same numbers gives about 3.0%, matching the guideline example. A white woman with this profile would be around 2.1%.
60-year-old male smoker on BP medication
Smoking, treated systolic pressure of 145 and HDL of 45 push the 10-year risk to about 22.5%, nearly four times the 5.7% of a 60-year-old man with optimal risk factors.
Frequently asked questions
What is a good ASCVD risk score?+
A 10-year risk below 5% is considered low. 5–7.4% is borderline, 7.5–19.9% intermediate and 20% or more high. Even a low 10-year risk can hide a high lifetime risk in younger adults, so healthy habits still matter.
What does ASCVD stand for?+
Atherosclerotic cardiovascular disease — conditions caused by plaque build-up in the arteries. The Pooled Cohort Equations predict “hard” events: non-fatal heart attack, death from coronary heart disease, and fatal or non-fatal stroke.
When is a statin recommended based on ASCVD risk?+
US guidelines suggest discussing a moderate-intensity statin for adults 40–75 with LDL 70–189 mg/dL and a 10-year risk of 7.5% or more, and considering it at 5–7.4% when risk-enhancing factors are present. The decision should be made with a clinician.
How is this different from the Framingham risk score?+
The Framingham score was based on a single mostly white Massachusetts cohort and predicted coronary events only. The Pooled Cohort Equations combine several US cohorts, include stroke, and have separate equations for African American adults.
Who should not use the ASCVD calculator?+
It is not meant for people who already have cardiovascular disease, those with LDL of 190 mg/dL or higher, or people younger than 40 or older than 79. Those groups are managed differently under the guidelines.
What about the newer PREVENT equations?+
In 2023 the AHA published the PREVENT equations, which add kidney function and remove race. They are gaining use, but the Pooled Cohort Equations remain the basis of the current ACC/AHA cholesterol guideline.
This tool gives general estimates and is not medical advice. Talk to a doctor or qualified professional about your health, diet or training.