Calculate your 10-year risk of atherosclerotic cardiovascular disease — heart attack and stroke using the ACC/AHA Pooled Cohort Equations. The most widely used cardiovascular risk tool in clinical practice.
Based on ACC/AHA 2013 Pooled Cohort Equations · Ages 40–79 · For adults without known CVD
The ASCVD Risk Calculator uses the 2013 ACC/AHA Pooled Cohort Equations to estimate your 10-year risk of a first atherosclerotic cardiovascular event defined as non-fatal myocardial infarction, coronary heart disease death, or fatal/non-fatal stroke. It is the most widely used cardiovascular risk tool in U.S. clinical practice and forms the foundation of current statin therapy and blood pressure treatment decisions.
The equations were derived from multiple large NHLBI-sponsored cohort studies including ARIC, the Cardiovascular Health Study, CARDIA, and the Framingham cohorts, representing both White and African-American adults aged 40–79. Reference: Goff DC et al., Circulation 2014;129(Suppl 2):S49–73.
Covers non-fatal heart attack, fatal coronary heart disease, and fatal or non-fatal stroke — the primary atherosclerotic events.
A risk ≥7.5% typically warrants moderate-intensity statin therapy; ≥20% warrants high-intensity therapy per 2019 ACC/AHA guidelines.
Derived from ARIC, CHS, CARDIA, and Framingham cohort studies. Sex-specific equations use interaction terms between age and risk factors.
This calculator requires six inputs from a standard physical exam and blood panel. Here is what each field means:
Once you click Calculate, your 10-year ASCVD risk percentage and risk category will appear. Share these results with your doctor — especially if your score is above 5%.
The ASCVD Pooled Cohort Equations (2013) remain the standard in clinical guidelines, but the newer AHA PREVENT equations (2023) represent a meaningful upgrade. Here is how to decide which to use:
A 10-year ASCVD score of 7.5% means you have a 7.5 in 100 chance of experiencing a heart attack or stroke over the next decade. This is the borderline-to-intermediate threshold in the ACC/AHA guidelines — the point at which a clinician-patient discussion about moderate-intensity statin therapy is formally recommended. It does not mean you will definitely have a heart attack; it means your risk is elevated enough to warrant a preventive conversation with your doctor.
The Pooled Cohort Equations use entirely separate coefficients for women versus men, reflecting the fact that cardiovascular risk accumulates differently across the female lifespan. Women generally have lower 10-year ASCVD scores than men of the same age, but this can be misleading — women who smoke, have diabetes, or have premature menopause face disproportionately elevated risk. The equations include an age-squared term for women (not present in the male equations) to capture the accelerating nature of cardiovascular risk post-menopause. If you are a woman aged 30–39, the ASCVD calculator does not apply — use the AHA PREVENT Calculator instead, which is validated from age 30.
According to the 2019 ACC/AHA Primary Prevention Guidelines, the formal thresholds are:
These are guidelines, not rules — your doctor will weigh your full clinical picture including coronary artery calcium (CAC) score, kidney function, and personal preferences before making a recommendation.
The Pooled Cohort Equations have three well-documented limitations that the 2023 AHA PREVENT calculator addresses:
For most patients today, running both calculators and discussing the results with your doctor gives the most complete picture of your cardiovascular risk.
Atherosclerotic Cardiovascular Disease.
Atherosclerotic refers to atherosclerosis — plaque building up inside artery walls. Cardiovascular is heart and blood vessels. Put them together and you get: disease of the heart and blood vessels driven by plaque.
It's an umbrella term, not a single condition. Heart attack and stroke are the two main events under it. Both happen when plaque ruptures, a clot forms, and blood flow to the heart or brain gets cut off.
When your doctor calculates your 10-year ASCVD risk, they're estimating your probability of a first heart attack or stroke over the next decade. That number is what drives statin prescribing decisions under current ACC/AHA guidelines.
ASCVD is atherosclerotic cardiovascular disease — heart attacks and strokes caused by narrowed, plaque-filled arteries.
LDL cholesterol particles get into artery walls and trigger inflammation. The body patches it. That patch, built up over years, is plaque. It thickens the artery wall, narrows the channel, and stiffens the vessel.
When a plaque ruptures, a clot forms at the site almost instantly. Block a coronary artery and it's a heart attack. Block a cerebral artery and it's a stroke.
Two conditions sit at the center of ASCVD clinically: coronary artery disease (plaque in the arteries feeding the heart) and cerebrovascular disease (plaque in arteries feeding the brain). Peripheral artery disease — plaque in the legs — uses the same mechanism but gets less attention in primary prevention.
The ASCVD calculator on this page estimates your 10-year risk of the first two. If you want heart failure included alongside them, the AHA PREVENT Calculator covers all 3 in one calculation.
A 10-year ASCVD risk below 5% is considered low risk and is associated with a focus on lifestyle optimization. Scores of 5–7.5% are borderline, 7.5–20% are intermediate (typically prompting statin discussions), and 20% or above is high risk. There is no universally "good" or "bad" number — what matters is the conversation with your doctor about how to interpret and act on your result.
Current 2019 ACC/AHA guidelines recommend that a 10-year ASCVD risk of 7.5% or higher warrants a clinician-patient discussion about moderate-intensity statin therapy. A risk of 20% or higher typically warrants high-intensity statin therapy. However, additional factors — including coronary artery calcium score, high-sensitivity CRP, and ankle-brachial index — may shift this decision in either direction.
The 2013 Pooled Cohort Equations were derived from cohorts of White and African-American adults and therefore include race-specific coefficients. This is a recognized limitation. Our calculator defaults to the White equations (which are the most widely used in primary care), but the underlying difference in the equations reflects differences in how cardiovascular risk was observed across the original study populations. The newer 2023 AHA PREVENT equations do not use race at all, which is one reason many clinicians are now transitioning to PREVENT.
The PCE has shown good discrimination in external validation studies (C-statistic ~0.78), meaning it correctly ranks who is at higher vs. lower risk. However, it tends to overestimate absolute risk in some contemporary populations because it was derived from cohorts collected before modern statin use became widespread. The PREVENT equations, derived from a larger, more contemporary dataset, are generally better calibrated for today's population.
No — the Pooled Cohort Equations are validated only for adults aged 40–79. If you are 30–39, use the AHA PREVENT Calculator instead, which is validated from age 30 and also provides 30-year risk estimates that are particularly informative for younger adults.
This flowchart shows how the ACC/AHA 2019 guidelines translate your 10-year ASCVD risk score into clinical recommendations for primary prevention — for adults without existing cardiovascular disease.