The only cardiovascular risk calculator that accepts your coronary artery calcium (CAC) score. Get your 10-year CHD risk and Coronary Age using the validated 2015 MESA equations.
McClelland RL et al., JACC 2015 · Ages 45–85 · CAC score optional
If you've had a coronary CT scan, enter your CAC score here. A score of 0 drops your risk significantly. Leave blank to calculate using traditional risk factors only.
The MESA CHD Risk Score was published by McClelland RL et al. in the Journal of the American College of Cardiology in 2015. It came out of the Multi-Ethnic Study of Atherosclerosis — a prospective cohort of 6,814 participants aged 45–84, free of clinical heart disease at baseline, tracked for 10 years across 6 U.S. field centers.
What makes MESA different from every other cardiovascular risk tool is the CAC score input. When you add your coronary artery calcium score, the model's C-statistic goes from 0.75 to 0.80. That's not a small improvement — it's enough to correctly reclassify thousands of borderline-risk patients who'd otherwise be given the wrong treatment decision.
A CAC of 0 can move an intermediate-risk patient down to low risk. A CAC of 400+ can do the opposite. No other validated online calculator does this.
Telling a 55-year-old their Coronary Age is 68 motivates action more reliably than saying "your risk is 14%." Same data, very different response.
ASCVD and PREVENT don't include family history of MI as a coefficient. MESA does — because the genetic contribution to CHD risk is real and measurable.
The CAC score can shift your risk estimate dramatically in both directions. Here's what each range means clinically:
Blaha MJ et al. derived Coronary Age from the MESA study and published it in JAHA in 2021. The math is straightforward: what age would a healthy person need to be, with normal blood pressure, normal cholesterol, no diabetes, no smoking, and no family history, to have the same 10-year CHD risk as you?
If your Coronary Age is significantly above your actual age, your risk factors are aging your cardiovascular system faster than the calendar. Below, and your heart is holding up well.
Clinically, Coronary Age tends to land harder than a percentage. A patient who hears "your risk is 14%" often doesn't know what to do with that. A patient who hears "your heart is 12 years older than your body" usually does.
A CAC of 0 means no detectable calcified plaque in your coronary arteries. It's the strongest negative cardiovascular predictor available — stronger than any single traditional risk factor. Even patients with borderline or intermediate risk scores (5–15%) can reasonably defer statin therapy when CAC=0, per 2018 ACC/AHA guidelines. The 10-year event rate for CAC=0 patients is typically below 2%.
Without CAC, MESA achieves a C-statistic of 0.75 — in line with other validated cardiovascular tools. Add the CAC score and it improves to 0.80. External validation in the Heinz Nixdorf Recall Study (Germany) and the Dallas Heart Study confirmed good discrimination and calibration in populations outside the original U.S. cohort.
Yes. The without-CAC version uses age, sex, race, cholesterol, blood pressure, diabetes, smoking, and family history to produce a validated 10-year CHD risk estimate. Coronary Age also works without CAC. You just get more accurate numbers when the calcium score is available.
A coronary calcium scan is available at most hospitals and imaging centers. It takes about 10 minutes, requires no contrast injection, and delivers a small radiation dose. Cost is typically $100–$400 and is sometimes covered by insurance. The 2018 ACC/AHA guidelines recommend it for borderline-risk adults (ASCVD 5–20%) where the statin decision isn't clear-cut.
Coronary Age is always calculated from the without-CAC model, per the Blaha et al. 2021 methodology. So you'll get a Coronary Age result whether or not you enter a CAC score. If you do have a CAC score, the primary risk percentage shown will reflect it — but the Coronary Age uses traditional factors only, by design.