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ASCVD Risk Calculator

This calculator estimates 10-year risk of a first atherosclerotic cardiovascular event (heart attack or stroke) using the ACC/AHA Pooled Cohort Equations. It is designed for primary prevention in adults aged 40–79 without known cardiovascular disease.

SI Units (mmol/L) US Units (mg/dL)
Demographics
Enter age between 40 and 79
Clinical Parameters
Enter value between 1 and 15 mmol/L
Enter value between 0.3 and 5 mmol/L
Enter value between 80 and 250 mmHg
Please complete all fields above
10-Year ASCVD Risk
-- %
--
Low
<5%
Borderline
5–7.5%
Intermediate
7.5–20%
High
>20%

What This Calculator Estimates

The Pooled Cohort Equations estimate the 10-year probability of a first atherosclerotic cardiovascular event, defined as non-fatal myocardial infarction, coronary heart disease death, or fatal or non-fatal stroke. The equations were derived from several large US longitudinal cohort studies including ARIC, CHS, CARDIA, and the Framingham offspring studies.

Results are expressed as a percentage. A result of 12% means approximately 12 out of every 100 people with the same risk profile would be expected to experience a cardiovascular event within 10 years.

When This Calculator Is Useful

The ASCVD risk calculator is primarily used to guide primary prevention decisions in adults aged 40–79 who do not have established cardiovascular disease. Current guidelines recommend statin therapy for patients with 10-year risk ≥7.5%, with more intensive therapy considered at ≥20%. For patients with borderline or intermediate risk, shared decision-making and risk-enhancing factors (family history, elevated Lp(a), hs-CRP, ABI) should inform treatment.

Limitations of Traditional Risk Calculators

The Pooled Cohort Equations have been shown to overestimate risk in some contemporary populations, particularly in lower-risk groups. They do not incorporate newer risk markers such as coronary artery calcium, Lp(a), or kidney function. The equations are validated primarily for US populations, with limited calibration data for non-US ethnic groups including Australians.

For patients where traditional risk assessment is insufficient, consider the AHA PREVENT calculator which incorporates metabolic and renal variables, or the MESA CAC calculator for direct imaging-based risk refinement.

References
  1. Arnett DK, Blumenthal RS, Fonarow GC, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2019;74(10):e177–e232.
  2. Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Circulation. 2014;129(25 Suppl 2):S49–S73.
  3. Muntner P, Colantonio LD, Cushman M, et al. Validation of the Atherosclerotic Cardiovascular Disease Pooled Cohort Risk Equations. JAMA. 2014;311(14):1406–1415.
  4. Rana JS, Tabada GH, Solomon MD, et al. Accuracy of the Atherosclerotic Cardiovascular Risk Equation in a Large Contemporary, Multiethnic Population. J Am Heart Assoc. 2016;5(4):e003099.
  5. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC Guideline on the Management of Blood Cholesterol. Circulation. 2019;139(25):e1082–e1143.