ASCVD Risk Calculator
10-year ASCVD risk from the ACC/AHA Pooled Cohort Equations, with the coefficients shown, where you sit among US adults, and what one changed input would do.
ASCVD Risk Calculator: with the default inputs, 10-year risk of a first hard ascvd event is 2.1%.
The equations were derived and validated in adults aged 40 to 79 and do not apply outside that range.
The equations were fitted separately for women and men.
The equations have only these two groups. For Hispanic, Asian and other groups the guideline directs you to the White equations of the same sex, and says so may over- or under-estimate risk.
Divide mmol/L by 0.02586 to get mg/dL — 5.5 mmol/L is about 213 mg/dL.
The top number.
Current smoking only. The equations have no term for former smoking.
Coronary death, non-fatal heart attack, or fatal or non-fatal stroke, within 10 years.
- Risk stratum
- under 2.5% — White women aged 40 to 79The strata the 2013 work group used to describe the US population.
- Share of that group in this stratum
- 47.1%Of US adults of the same sex and race aged 40 to 79 (NHANES 2007-2010).
- What the USPSTF says at this risk
- Below 7.5% this estimate sits under both USPSTF (2022) statin thresholds for adults aged 40 to 75.
- Individual sum (coefficient × value)
- -29.6767The linear predictor before it is compared with the group mean.
- Group mean sum
- -29.18The race- and sex-specific mean the individual sum is measured against.
- Risk at 79 with these same risk factors
- 21.2%What the equation returns at the top of its validated age range, holding everything else fixed.
Assumptions
- This is an estimate for education. It does not diagnose anything and does not replace a clinician.
- Coefficients, race- and sex-specific mean sums and baseline survivals are taken from tables 4a and 4b of the NHLBI Risk Assessment Work Group report, 2013.
- Risk = 1 − S10 ^ exp(individual sum − group mean sum), with cholesterol in mg/dL and blood pressure in mmHg.
- Valid only for adults aged 40 to 79 with no prior ASCVD; the calculator returns an error rather than extrapolating outside that range.
- Only two race groups exist in the model. For all other groups the guideline directs you to the White equations of the same sex, which may over- or under-estimate risk.
- The equations estimate risk in the absence of treatment, so the one-input-changed table shows model outputs, not the benefit of any intervention.
- The AHA's 2023 PREVENT equations are the successor model and are not implemented here, because their coefficients are not publicly retrievable from a primary source.
| Scenario | 10-year risk | Change |
|---|---|---|
| As entered | 2.1% | — |
| If total cholesterol were 170 mg/dL | 1.6% | -0.4 points |
| If HDL were 60 mg/dL | 1.7% | -0.3 points |
| If diabetes were present | 3.9% | +1.9 points |
| If a current smoker | 5% | +2.9 points |
These are what the model returns with one input altered. They are not a prediction of how much any treatment would reduce your risk — the equations were fitted on untreated risk, and only a trial can say what an intervention does.
| 10-year risk | Share of that group | |
|---|---|---|
| under 2.5% | 47.1% | ← you |
| 2.5 to 4.9% | 20.4% | |
| 5.0 to 7.4% | 10.7% | |
| 7.5 to 9.9% | 5.1% | |
| 10.0 to 14.9% | 5.5% | |
| 15.0 to 19.9% | 4.1% | |
| 20% or more | 7.1% |
Applying these equations to NHANES 2007-2010: 5,367 CVD-free, non-pregnant US adults aged 40 to 79, weighted to 100,542,000 people (table 12 of the work group report).
How this is worked out
The formula
risk = 1 − S10 ^ exp(individual sum − group mean sum)
individual sum = Σ coefficient × value, over:
ln(age), ln(age)², ln(total cholesterol), ln(age)×ln(total cholesterol),
ln(HDL), ln(age)×ln(HDL), ln(systolic BP) — treated or untreated,
ln(age)×ln(systolic BP), current smoker, ln(age)×current smoker, diabetes
S10 = the group's baseline 10-year survival
group mean = the race- and sex-specific mean of the individual sum
Terms not present in a group's equation have a coefficient of zero. Cholesterol is in
mg/dL, blood pressure in mmHg, age in years.Open How it’s calculated above to see this worked through with your own numbers.
What you enter
- Age
- The equations were derived and validated in adults aged 40 to 79 and do not apply outside that range.from 40 to 79 · whole numbers only · defaults to 55
- Sex
- The equations were fitted separately for women and men.Female · Male
- Race
- The equations have only these two groups. For Hispanic, Asian and other groups the guideline directs you to the White equations of the same sex, and says so may over- or under-estimate risk.White, or another race · Black or African American
- Total cholesterol
- Divide mmol/L by 0.02586 to get mg/dL — 5.5 mmol/L is about 213 mg/dL.from 100 to 400 · defaults to 213
- HDL cholesterol
- A number.from 15 to 120 · defaults to 50
- Systolic blood pressure
- The top number.from 80 to 220 · defaults to 120
- Taking blood pressure medication
- Turn this on or off.defaults to off
- Current smoker
- Current smoking only. The equations have no term for former smoking.defaults to off
- Diabetes
- Turn this on or off.defaults to off
What you get back
- 10-year risk of a first hard ASCVD eventmain answer
- Coronary death, non-fatal heart attack, or fatal or non-fatal stroke, within 10 years.
- Risk stratum
- The strata the 2013 work group used to describe the US population.
- Share of that group in this stratum
- Of US adults of the same sex and race aged 40 to 79 (NHANES 2007-2010).
- What the USPSTF says at this risk
- Individual sum (coefficient × value)
- The linear predictor before it is compared with the group mean.
- Group mean sum
- The race- and sex-specific mean the individual sum is measured against.
- Risk at 79 with these same risk factors
- What the equation returns at the top of its validated age range, holding everything else fixed.
What this assumes
- This is an estimate for education. It does not diagnose anything and does not replace a clinician.
- Coefficients, race- and sex-specific mean sums and baseline survivals are taken from tables 4a and 4b of the NHLBI Risk Assessment Work Group report, 2013.
- Risk = 1 − S10 ^ exp(individual sum − group mean sum), with cholesterol in mg/dL and blood pressure in mmHg.
- Valid only for adults aged 40 to 79 with no prior ASCVD; the calculator returns an error rather than extrapolating outside that range.
- Only two race groups exist in the model. For all other groups the guideline directs you to the White equations of the same sex, which may over- or under-estimate risk.
- The equations estimate risk in the absence of treatment, so the one-input-changed table shows model outputs, not the benefit of any intervention.
- The AHA's 2023 PREVENT equations are the successor model and are not implemented here, because their coefficients are not publicly retrievable from a primary source.
About this calculator
This is an estimate for education. It does not diagnose anything and does not replace a clinician. It reports what happened, over ten years, to groups of people who looked like this on paper. Nobody should start or stop a medicine because of a number on a web page.
What it computes
The Pooled Cohort Equations estimate the 10-year risk of a first hard ASCVD event — coronary death, non-fatal myocardial infarction, or fatal or non-fatal stroke — in an adult who has none of those already. They were built by the NHLBI Risk Assessment Work Group from five community cohorts: ARIC, the Cardiovascular Health Study, CARDIA, and the Framingham Original and Offspring cohorts. The model was fitted on 11,240 White women (902 events), 9,098 White men (1,259), 2,641 African American women (290) and 1,647 African American men (238), all aged 40 to 79, all free of prior heart attack, stroke, heart failure, revascularisation or atrial fibrillation.
The coefficients here come from tables 4a and 4b of the work group's own report, not from another calculator. The results panel prints the individual sum, the group mean and the baseline survival, so you can check the arithmetic against the source.
The validated range, and what happens outside it
Ages 40 to 79. People older than 79 were excluded from the derivation "due to complex age-covariate interactions", and the equations were never fitted below 40. This calculator refuses to extrapolate rather than return a number that looks authoritative and is not.
There are only two race groups, because those were the only two in the cohorts. The work group's instruction for everyone else is explicit: use the equations for Whites of the same sex, accepting that this "may provide overestimation of risk for some groups (e.g., East Asian Americans) and underestimation in others (e.g., South Asian Americans)".
Why not PREVENT?
The AHA published PREVENT in 2023 as the successor: it covers ages 30 to 79, predicts total cardiovascular disease and heart failure as well as ASCVD, adds kidney function and metabolic factors, uses contemporary cohorts, and — importantly — removes race as an input, treating it as the social variable it is rather than a biological one. It is the better model, and it is where the field is going.
It is not implemented here because its coefficients live in a supplementary appendix that is not publicly retrievable, and this site does not ship a clinical model transcribed from somebody else's calculator. The Pooled Cohort Equations, by contrast, are published in full by the NHLBI, and they remain the tool the US Preventive Services Task Force names in its 2022 statin recommendation. If you want PREVENT, use the AHA's own calculator.
Reading the result
The risk stratum and the population table come from the work group applying these same equations to NHANES 2007-2010, so "8.2%" becomes "higher than about four in five women my age and race". The USPSTF line gives the thresholds a US clinician is likely to be working from: 10% or more is a grade B recommendation to prescribe a statin for adults 40 to 75 with at least one risk factor; 7.5% to 10% is a grade C, meaning offer it selectively.
The table of one-input changes shows what the equation returns when one thing moves. It is not a forecast of what any treatment would achieve. And the equations carry no term for family history, former smoking, obesity, exercise, kidney function, coronary calcium or lipoprotein(a) — a reassuring number is not the end of the conversation.
Frequently asked questions
▸What counts as a hard ASCVD event?
Coronary heart disease death, non-fatal myocardial infarction, or fatal or non-fatal stroke — first occurrence, in someone with no prior ASCVD. Coronary revascularisation was deliberately excluded because it reflects referral patterns as much as disease.
▸Why does it refuse to run outside ages 40 to 79?
Because the equations were fitted on adults aged 40 to 79, and people over 79 were excluded from the derivation for complex age interactions. Outside that window the model is extrapolating, so this calculator declines rather than printing a number that looks official.
▸Why does it ask about race?
Because the 2013 equations were fitted separately for White and African American participants and have no other groups. Race here is a statistical artefact of the cohorts, not biology, and the AHA's 2023 PREVENT equations removed it for exactly that reason.
▸Does the Pooled Cohort Equation over-predict?
Often, yes. The work group itself warned that falling ASCVD incidence "may lead to an overestimation of the predicted risks", and independent validation in contemporary cohorts has generally found over-prediction, particularly at higher estimated risk.
▸What risk means I should be on a statin?
That is a decision for you and a clinician. For context, the USPSTF in 2022 recommended prescribing a statin for adults aged 40 to 75 with at least one risk factor and a 10-year risk of 10% or more, and selectively offering one between 7.5% and 10%.
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