ASCVD Risk Calculator
Estimate your 10-year risk of a first atherosclerotic cardiovascular event (heart attack or stroke) using the ACC/AHA Pooled Cohort Equations. This is the same calculator clinicians use to guide statin therapy decisions under the 2018 guidelines.
The Pooled Cohort Equations (PCE) were developed by the American College of Cardiology and American Heart Association in 2013, using data from multiple large US population studies. They estimate the 10-year risk of a first "hard" ASCVD event: nonfatal heart attack, coronary heart disease death, or fatal or nonfatal stroke.
Risk factors in the calculation:
- Age (40-79 years)
- Sex (separate equations for men and women)
- Race (separate coefficients for White and African American individuals)
- Total cholesterol and HDL cholesterol
- Systolic blood pressure and treatment status
- Diabetes status
- Current smoking status
Risk categories (2018 AHA/ACC):
- Low risk (<5%): Focus on healthy lifestyle. Statins generally not recommended.
- Borderline risk (5 to <7.5%): Discuss with your doctor. Risk-enhancing factors may tip the decision toward statin therapy.
- Intermediate risk (7.5 to <20%): Moderate-intensity statin generally recommended. A coronary artery calcium (CAC) score of 0 may allow deferral.
- High risk (20%+): High-intensity statin therapy is strongly recommended.
Risk-enhancing factors that may shift clinical decisions include: family history of premature ASCVD, LDL 160+ mg/dL, metabolic syndrome, chronic kidney disease, chronic inflammatory conditions (like rheumatoid arthritis), premature menopause, preeclampsia history, South Asian ancestry, and elevated biomarkers (hsCRP, Lp(a), apoB).
Limitations: The PCE may overestimate risk in some populations and underestimate it in others. It was developed primarily from White and African American cohorts. For other racial/ethnic groups, the estimates may be less accurate. The calculator does not account for family history, which is a significant risk factor.
This tool is for educational purposes only and should not replace professional medical advice.