ASCVD Risk Calculator
Estimate your 10-year risk of atherosclerotic cardiovascular disease (heart attack, stroke) using the Pooled Cohort Equations from the 2013 ACC/AHA guidelines.
Valid for ages 40-79
Equation validated for White and African American; "Other" uses White coefficients
What is ASCVD Risk?
ASCVD (Atherosclerotic Cardiovascular Disease) includes heart attacks, strokes, and peripheral artery disease caused by plaque buildup. This calculator estimates your 10-year risk using the Pooled Cohort Equations, helping guide preventive treatment decisions like statin therapy.
How to Use This Calculator
- Enter your age (40-79 years), sex, and race
- Enter total and HDL cholesterol from a recent lipid panel
- Enter systolic blood pressure and treatment status
- Indicate diabetes and smoking status
- Click "Calculate Risk" for your 10-year ASCVD risk
Frequently Asked Questions
Per 2018 ACC/AHA guidelines: statins are recommended if 10-year risk ≥7.5% (intermediate) or ≥20% (high). For borderline risk (5-7.5%), consider risk-enhancing factors. For all groups, shared decision-making with your provider is important to weigh benefits vs. potential side effects.
Risk-enhancing factors include: family history of premature ASCVD, LDL-C ≥160, metabolic syndrome, chronic kidney disease, inflammatory conditions (RA, lupus, psoriasis), South Asian ancestry, persistently elevated triglycerides ≥175, apoB ≥130, Lp(a) ≥50, and premature menopause.
CAC scoring uses CT scan to detect calcified plaque in coronary arteries. It's useful for borderline/intermediate risk patients. CAC of 0 indicates very low risk (statins may be deferred); CAC ≥100 or ≥75th percentile for age/sex favors statin therapy.
The Pooled Cohort Equations were derived from studies that found different baseline ASCVD rates between racial groups. This reflects population-level differences in outcomes, not biology. The equation was validated only in White and African American populations; results for other groups should be interpreted cautiously.
Some studies suggest the PCE may overestimate risk in some populations, particularly those with few risk factors. This is why 2018 guidelines introduced CAC scoring and risk-enhancing factors to refine estimates. Discuss with your provider if you have concerns about your calculated risk.
Calculator Limitations
- Age range: Only validated for ages 40-79
- Race: Validated only for White and African American populations
- Existing ASCVD: Not for patients with known cardiovascular disease
- LDL ≥190: High-intensity statins recommended regardless of calculated risk
- Diabetes ages 40-75: Moderate-intensity statins recommended regardless of risk
Medical Disclaimer: This calculator is for educational purposes and to support clinical decision-making. It should not replace clinical judgment. Treatment decisions should be made in consultation with a healthcare provider considering individual patient factors.
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