ASCVD Risk Calculator (Pooled Cohort Equations)
Estimate your 10-year risk of atherosclerotic cardiovascular disease (ASCVD) — heart attack, coronary death, and fatal or non-fatal stroke — with the 2013 ACC/AHA Pooled Cohort Equations. This is the score used to guide statin decisions in adults aged 40–79 without existing cardiovascular disease. The equations are sex- and race-specific; enter cholesterol in mg/dL.
How this is calculated
Equation. 10-year risk = 1 − S₀ raised to the power exp(Σ βᵢ·xᵢ − mean) — sex- and race-specific, with log-transformed predictors and age-interaction terms.
| Term | Meaning |
|---|---|
| Sex | Male or female (separate equations) |
| Race | White or other, or African American (separate equations) |
| Age | Years (validated 40–79) |
| Total cholesterol | mg/dL |
| HDL cholesterol | mg/dL |
| Systolic BP | mmHg, with a separate coefficient when treated for high blood pressure |
| Smoking | Current smoker (yes / no) |
| Diabetes | Diabetic (yes / no) |
The β coefficients, baseline survival S₀ and centring means are the sex- and race-specific values from the cited source. Bands: low < 5%, borderline 5–7.5%, intermediate 7.5–20%, high ≥ 20%; a statin is generally considered from a 10-year risk of 7.5%. Source: Goff DC et al., 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk, Circulation 2014;129(25 Suppl 2):S49–S73.
Frequently asked questions
What is the ASCVD risk score?
The ASCVD risk score is a 10-year estimate of your risk of a first hard atherosclerotic cardiovascular event — non-fatal heart attack, death from coronary heart disease, or fatal or non-fatal stroke. It comes from the 2013 ACC/AHA Pooled Cohort Equations, developed to help decide who benefits from statin therapy. The inputs are sex, race, age, total and HDL cholesterol, systolic blood pressure and whether it is treated, smoking and diabetes.
What ASCVD risk is considered high?
The ACC/AHA risk categories are: low, under 5%; borderline, 5% to under 7.5%; intermediate, 7.5% to under 20%; and high, 20% or more. A 10-year risk of 7.5% or higher is the usual threshold at which a moderate-to-high-intensity statin is considered, and 5–7.5% may prompt a discussion when other risk-enhancing factors are present. This calculator labels each result with those same four bands. Because the bands describe absolute 10-year risk, a younger adult with several risk factors can still fall in the low band while an untreated 70-year-old with none may not — which is why the score is read alongside age, family history and lifetime risk rather than on its own.
Why does the calculator ask for race?
The 2013 Pooled Cohort Equations were published with separate coefficients for white and African American men and women, so race changes the estimate. People of other backgrounds are advised to use the “white or other” equations, which are less accurate for them. Newer tools such as the 2023 AHA PREVENT equations remove race in favour of other variables; this calculator reproduces the original 2013 equations still used in many guidelines.
Who is the score valid for?
The ASCVD risk score applies to adults aged 40–79 who do not already have clinical cardiovascular disease. It is not validated below 40 or above 79, and it can over- or under-estimate risk in some groups. People with LDL ≥ 190 mg/dL, or with diabetes aged 40–75, are already statin candidates regardless of the score.
My cholesterol is in mmol/L — how do I enter it?
Multiply mmol/L by 38.67 to get mg/dL for both total and HDL cholesterol. For example, total cholesterol of 5.5 mmol/L is about 213 mg/dL and HDL of 1.3 mmol/L is about 50 mg/dL. Enter the mg/dL values.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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