# What is my 10-year ASCVD risk?

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.

- Page: https://www.acalculator.org/health/ascvd-risk-calculator
- JSON spec: https://www.acalculator.org/health/ascvd-risk-calculator.json
- Version: 4cb030d0dbf5

## Default answer

Example with the default inputs (Sex Male, Race White or other, Age 55, Cholesterol units mg/dL, Total cholesterol (mg/dL) 213, HDL cholesterol (mg/dL) 50, Systolic blood pressure (mmHg) 120, Taking blood pressure medicine No, Diabetes No, Current smoker No): Your estimated 10-year ASCVD risk is 5.4%, which is Borderline risk (5% to 7.4%).

## Inputs

| Key | Label | Description |
| --- | --- | --- |
| sex | Sex | Sex at birth. The equations differ for women and men. |
| race | Race | The equations were fitted for African American and for White adults. The guideline uses the White equations for other groups. |
| age | Age | Age in whole years, 40 to 79. |
| units | Cholesterol units | US units (mg/dL) or SI units (mmol/L) for total and HDL cholesterol. |
| tc | Total cholesterol (mg/dL) | Total cholesterol, 130 to 320 mg/dL. |
| tcSi | Total cholesterol (mmol/L) | Total cholesterol, 3.37 to 8.27 mmol/L. |
| hdl | HDL cholesterol (mg/dL) | HDL cholesterol, 20 to 100 mg/dL. |
| hdlSi | HDL cholesterol (mmol/L) | HDL cholesterol, 0.52 to 2.58 mmol/L. |
| sbp | Systolic blood pressure (mmHg) | The top number of the blood pressure, 90 to 200 mmHg. |
| bpMeds | Taking blood pressure medicine | Whether you take medicine for high blood pressure. |
| diabetes | Diabetes | Whether you have diabetes. |
| smoker | Current smoker | Whether you smoke cigarettes now. |

## Outputs

| Key | Label | Description |
| --- | --- | --- |
| risk | 10-year ASCVD risk | Chance of a first heart attack, death from coronary heart disease, or stroke in the next 10 years, rounded to 0.1%. |
| category | Risk category | The 2018 AHA/ACC cholesterol guideline category for the rounded risk. |
| equation | Equation used | Which of the four Pooled Cohort Equations the calculator used. |

## 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.

## Worked examples

1. sex = female, race = white, age = 55, units = us, tc = 213, hdl = 50, sbp = 120, bpMeds = no, diabetes = no, smoker = no gives 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%.
2. sex = female, race = black, age = 55, units = us, tc = 213, hdl = 50, sbp = 120, bpMeds = no, diabetes = no, smoker = no gives 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%.
3. sex = male, race = white, age = 55, units = us, tc = 213, hdl = 50, sbp = 120, bpMeds = no, diabetes = no, smoker = no gives 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.
4. sex = male, race = black, age = 55, units = us, tc = 213, hdl = 50, sbp = 120, bpMeds = no, diabetes = no, smoker = no gives 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%.
5. sex = male, race = white, age = 60, units = si, tcSi = 5.172, hdlSi = 1.1637, sbp = 140, bpMeds = yes, diabetes = yes, smoker = yes gives 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%.

## FAQ

### What is ASCVD?

Atherosclerotic cardiovascular disease (ASCVD) is disease caused by plaque in the arteries. The Pooled Cohort Equations count a "hard" ASCVD event: a heart attack that is not fatal, death from coronary heart disease, or a stroke (fatal or not).

### What do the risk categories mean?

The 2018 AHA/ACC cholesterol guideline groups 10-year risk as low (under 5%), borderline (5% to 7.4%), intermediate (7.5% to 19.9%), and high (20% or more). The guideline uses these groups to start a conversation between a patient and a clinician about prevention. This page does not recommend a treatment.

### Why does the calculator ask about race?

The 2013 equations were fitted separately for African American and White adults, because their risk differed in the cohort data. For other groups the guideline uses the White equations, which may overestimate risk for East Asian adults and underestimate it for South Asian adults. The newer PREVENT equations (2024) do not use race.

### Who should not use the ASCVD risk calculator?

People who already have heart disease, a stroke, or peripheral artery disease; people with LDL cholesterol of 190 mg/dL or more; and people outside ages 40 to 79. The equations were not built for them.

### What is the difference between the ASCVD calculator and PREVENT?

PREVENT (Khan and others, 2024) is a newer set of equations from the American Heart Association. It works from age 30, adds kidney function, estimates heart failure too, and does not use race. It usually gives lower risks than the Pooled Cohort Equations. See the PREVENT calculator.

## 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)