ASCVD Risk Calculator

ASCVD stands for Atherosclerotic Cardiovascular Disease. It refers to conditions caused by the buildup of plaque (atherosclerosis) in artery walls, including coronary heart disease, stroke, and peripheral artery disease. ASCVD is a leading cause of death and disability worldwide.

The 10-year ASCVD risk score estimates the probability that a person will experience a first major atherosclerotic cardiovascular event — such as a heart attack or stroke — within the next 10 years. A score below 5% is considered low risk, 5–7.5% borderline, 7.5–20% intermediate, and 20% or higher is high risk.

This calculator implements the ACC/AHA Pooled Cohort Equations, published in the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. The equations were derived from multiple large community-based cohort studies and are designed for use in patients aged 40–79 without pre-existing cardiovascular disease.

For patients at borderline risk (5–7.5%), lifestyle modification is typically the first step. Intermediate-risk patients (7.5–20%) generally benefit from statin therapy in addition to lifestyle changes. High-risk patients (≥20%) are candidates for high-intensity statin therapy. Your clinician will also consider additional risk-enhancing factors and patient preferences.

This calculator is intended for adults aged 40–79 who have no prior history of ASCVD (no previous heart attack, stroke, or known cardiovascular disease). It is not validated for patients who are already on statin therapy or for those with familial hypercholesterolemia. Always consult a healthcare provider for clinical decisions.

The calculator needs age, sex, race/ethnicity, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure treatment status, diabetes status, and current smoking status. All of these are standard values obtained in a routine clinical assessment.

Clinicians use ASCVD risk scores to guide shared decision-making about initiating statin therapy, aspirin use, lifestyle counseling, and other preventive interventions. The score helps identify patients most likely to benefit from treatment while avoiding unnecessary medication in low-risk individuals.

Beyond the standard inputs, risk-enhancing factors include LDL ≥160 mg/dL, metabolic syndrome, chronic kidney disease, inflammatory conditions (e.g., rheumatoid arthritis, lupus), premature menopause, family history of premature ASCVD, and high-sensitivity CRP ≥2.0 mg/L. A coronary artery calcium (CAC) score can also help reclassify borderline-risk patients.