{
  "id": "ascvd-risk",
  "version": "4cb030d0dbf5",
  "status": "published",
  "name": "ASCVD Risk Calculator",
  "question": "What is my 10-year ASCVD risk?",
  "summary": "Estimates the 10-year risk of a first heart attack or stroke (hard ASCVD) for adults 40 to 79 with the Pooled Cohort Equations of the 2013 ACC/AHA guideline, and shows the 2018 guideline risk category.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/ascvd-risk-calculator",
  "markdown": "https://www.acalculator.org/health/ascvd-risk-calculator.md",
  "kind": "function",
  "method": "Risk = 1 − S10^exp(Σ coefficient × value − mean), with the natural logs of age, total cholesterol, HDL cholesterol, and systolic blood pressure, and the coefficients, baseline survival S10, and mean of Goff 2013 Table A for each of the four sex and race groups.",
  "assumptions": [
    "Adults 40 to 79 without known heart disease or stroke, with LDL cholesterol under 190 mg/dL (the guideline treats 190 or more separately).",
    "Other races and ethnic groups use the White equations, as the guideline says.",
    "mmol/L is converted to mg/dL by dividing by 0.02586.",
    "The risk is rounded to 0.1%, and the category is read from the rounded risk."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "sex": {
        "title": "Sex",
        "description": "Sex at birth. The equations differ for women and men.",
        "type": "string",
        "enum": [
          "male",
          "female"
        ]
      },
      "race": {
        "title": "Race",
        "description": "The equations were fitted for African American and for White adults. The guideline uses the White equations for other groups.",
        "type": "string",
        "enum": [
          "white",
          "black"
        ]
      },
      "age": {
        "title": "Age",
        "description": "Age in whole years, 40 to 79.",
        "type": "integer",
        "minimum": 40,
        "maximum": 79
      },
      "units": {
        "title": "Cholesterol units",
        "description": "US units (mg/dL) or SI units (mmol/L) for total and HDL cholesterol.",
        "type": "string",
        "enum": [
          "us",
          "si"
        ]
      },
      "tc": {
        "title": "Total cholesterol (mg/dL)",
        "description": "Total cholesterol, 130 to 320 mg/dL.",
        "type": "number",
        "minimum": 130,
        "maximum": 320
      },
      "tcSi": {
        "title": "Total cholesterol (mmol/L)",
        "description": "Total cholesterol, 3.37 to 8.27 mmol/L.",
        "type": "number",
        "minimum": 3.37,
        "maximum": 8.27
      },
      "hdl": {
        "title": "HDL cholesterol (mg/dL)",
        "description": "HDL cholesterol, 20 to 100 mg/dL.",
        "type": "number",
        "minimum": 20,
        "maximum": 100
      },
      "hdlSi": {
        "title": "HDL cholesterol (mmol/L)",
        "description": "HDL cholesterol, 0.52 to 2.58 mmol/L.",
        "type": "number",
        "minimum": 0.52,
        "maximum": 2.58
      },
      "sbp": {
        "title": "Systolic blood pressure (mmHg)",
        "description": "The top number of the blood pressure, 90 to 200 mmHg.",
        "type": "number",
        "minimum": 90,
        "maximum": 200
      },
      "bpMeds": {
        "title": "Taking blood pressure medicine",
        "description": "Whether you take medicine for high blood pressure.",
        "type": "boolean"
      },
      "diabetes": {
        "title": "Diabetes",
        "description": "Whether you have diabetes.",
        "type": "boolean"
      },
      "smoker": {
        "title": "Current smoker",
        "description": "Whether you smoke cigarettes now.",
        "type": "boolean"
      }
    }
  },
  "outputs": {
    "risk": {
      "label": "10-year ASCVD risk",
      "description": "Chance of a first heart attack, death from coronary heart disease, or stroke in the next 10 years, rounded to 0.1%.",
      "format": "percent"
    },
    "category": {
      "label": "Risk category",
      "description": "The 2018 AHA/ACC cholesterol guideline category for the rounded risk.",
      "format": "text"
    },
    "equation": {
      "label": "Equation used",
      "description": "Which of the four Pooled Cohort Equations the calculator used.",
      "format": "text"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "sex": "male",
      "race": "white",
      "age": 55,
      "units": "us",
      "tc": 213,
      "tcSi": 5.5,
      "hdl": 50,
      "hdlSi": 1.3,
      "sbp": 120,
      "bpMeds": false,
      "diabetes": false,
      "smoker": false
    },
    "outputs": {
      "risk": 5.4,
      "category": "Borderline risk (5% to 7.4%)",
      "equation": "White men"
    },
    "text": "Your estimated 10-year ASCVD risk is 5.4%, which is Borderline risk (5% to 7.4%)."
  },
  "examples": [
    {
      "given": {
        "sex": "female",
        "race": "white",
        "age": 55,
        "units": "us",
        "tc": 213,
        "hdl": 50,
        "sbp": 120,
        "bpMeds": false,
        "diabetes": false,
        "smoker": false
      },
      "expect": {
        "risk": 2.1,
        "category": "Low risk (under 5%)"
      },
      "source": "Goff et al., Circulation 2014, Table A example profile and White-women coefficients: sum −29.6767, 1 − 0.9665^exp(−29.6767 + 29.18) = 2.052%, shown as 2.1% (hand calculation in content.mdx; Python 3 check in docs/progress/WP-88.md)"
    },
    {
      "given": {
        "sex": "female",
        "race": "black",
        "age": 55,
        "units": "us",
        "tc": 213,
        "hdl": 50,
        "sbp": 120,
        "bpMeds": false,
        "diabetes": false,
        "smoker": false
      },
      "expect": {
        "risk": 3,
        "category": "Low risk (under 5%)"
      },
      "source": "Goff et al. 2014, Table A example profile, African American women: sum 86.1677, 1 − 0.9533^exp(86.1677 − 86.61) = 3.026%, shown as 3.0% (Python 3 check)"
    },
    {
      "given": {
        "sex": "male",
        "race": "white",
        "age": 55,
        "units": "us",
        "tc": 213,
        "hdl": 50,
        "sbp": 120,
        "bpMeds": false,
        "diabetes": false,
        "smoker": false
      },
      "expect": {
        "risk": 5.4,
        "category": "Borderline risk (5% to 7.4%)"
      },
      "source": "Goff et al. 2014, Table A example profile, White men: sum 60.6995, 1 − 0.9144^exp(60.6995 − 61.18) = 5.384%, shown as 5.4%. The guideline text prints 5.3% for this profile, from the sum cut to 60.69 (Python 3 check in docs/progress/clinical-publish/examples-check.py)"
    },
    {
      "given": {
        "sex": "male",
        "race": "black",
        "age": 55,
        "units": "us",
        "tc": 213,
        "hdl": 50,
        "sbp": 120,
        "bpMeds": false,
        "diabetes": false,
        "smoker": false
      },
      "expect": {
        "risk": 6.1,
        "category": "Borderline risk (5% to 7.4%)"
      },
      "source": "Goff et al. 2014, Table A example profile, African American men: sum 18.9728, 1 − 0.8954^exp(18.9728 − 19.54) = 6.073%, shown as 6.1% (Python 3 check)"
    },
    {
      "given": {
        "sex": "male",
        "race": "white",
        "age": 60,
        "units": "si",
        "tcSi": 5.172,
        "hdlSi": 1.1637,
        "sbp": 140,
        "bpMeds": true,
        "diabetes": true,
        "smoker": true
      },
      "expect": {
        "risk": 34.5,
        "category": "High risk (20% or more)"
      },
      "source": "Goff et al. 2014 Table A equation for White men: sum 62.7328, 1 − 0.9144^exp(62.7328 − 61.18) = 34.48%, shown as 34.5% (hand calculation in content.mdx; Python 3 check)"
    }
  ],
  "sources": [
    "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, Table A. https://doi.org/10.1161/01.cir.0000437741.48606.98 (retrieved 2026-09-28)",
    "Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Circulation. 2019;139(25):e1082-e1143. https://doi.org/10.1161/CIR.0000000000000625 (risk categories; retrieved 2026-09-28)",
    "Khan SS, Matsushita K, Sang Y, et al. Development and validation of the American Heart Association PREVENT equations. Circulation. 2024;149(6):430-449. https://doi.org/10.1161/CIRCULATIONAHA.123.067626 (cholesterol conversion 0.02586; retrieved 2026-09-28)",
    "Mayer MG. preventr: an implementation of the AHA PREVENT and Pooled Cohort Equations (R package, used only to check results). https://github.com/martingmayer/preventr (retrieved 2026-09-28)"
  ],
  "related": [],
  "changelog": [
    {
      "date": "2026-09-29",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notice says so."
    }
  ]
}