# What is my CHA2DS2-VASc score?

Adds up the CHA2DS2-VASc score (Lip 2010) for stroke risk in atrial fibrillation, from age, sex, and five yes-or-no conditions, and shows the risk group.

- Page: https://www.acalculator.org/health/chads-vasc-calculator
- JSON spec: https://www.acalculator.org/health/chads-vasc-calculator.json
- Version: d5490241dc44

## Default answer

Example with the default inputs (Age 70, Sex Female, Heart failure No, High blood pressure No, Diabetes No, Stroke, TIA, or blood clot No, Vascular disease No): The CHA2DS2-VASc score is 2 (Intermediate risk).

## Inputs

| Key | Label | Description |
| --- | --- | --- |
| age | Age | Age in whole years. 65 to 74 scores 1 point, 75 or older scores 2. |
| sex | Sex | Sex at birth. Female sex scores 1 point. |
| chf | Heart failure | Heart failure, or moderate to severe left ventricular dysfunction on a scan (1 point). |
| htn | High blood pressure | High blood pressure, treated or not (1 point). |
| dm | Diabetes | Diabetes (1 point). |
| stroke | Stroke, TIA, or blood clot | A past stroke, transient ischemic attack (TIA), or thromboembolism (2 points). |
| vascular | Vascular disease | A past heart attack, peripheral artery disease, or aortic plaque (1 point). |

## Outputs

| Key | Label | Description |
| --- | --- | --- |
| score | CHA2DS2-VASc score | The total score, 0 to 9. |
| group | Risk group | Low, intermediate, or high stroke risk for the score and sex. |
| parts | Points counted | The items that scored points. |

## Method

Score = heart failure (1) + high blood pressure (1) + age ≥ 75 (2) + diabetes (1) + stroke, TIA, or thromboembolism (2) + vascular disease (1) + age 65 to 74 (1) + female (1).

## Assumptions

- For adults with atrial fibrillation or flutter that is not caused by a mechanical heart valve or moderate to severe mitral stenosis.
- Age 65 to 74 scores 1 point and 75 or older 2 points, never both.
- The risk group counts every point except the female point: 0 other points is low, 1 is intermediate, 2 or more is high.

## Worked examples

1. age = 70, sex = female, chf = no, htn = no, dm = no, stroke = no, vascular = no gives score = 2, group = Intermediate risk, parts = age 65 to 74 1, female 1. Source: Lip et al., Chest 2010, Table 1 point values: age 65 to 74 (1) + female (1) = 2 ().
2. age = 80, sex = male, chf = yes, htn = yes, dm = yes, stroke = yes, vascular = yes gives score = 8, group = High risk. Source: Lip et al. 2010: C1 + H1 + A2 + D1 + S2 + V1 = 8.
3. age = 76, sex = female, chf = yes, htn = yes, dm = yes, stroke = yes, vascular = yes gives score = 9, group = High risk. Source: Lip et al. 2010: the maximum score is 9 ().
4. age = 50, sex = male, chf = no, htn = no, dm = no, stroke = no, vascular = no gives score = 0, group = Low risk, parts = none. Source: Lip et al. 2010: no risk factors scores 0 ().
5. age = 60, sex = female, chf = no, htn = yes, dm = no, stroke = no, vascular = no gives score = 2, group = Intermediate risk. Source: 2023 ACC/AHA/ACCP/HRS AF guideline: the risk group is read without the sex point, so a woman with high blood pressure (score 2) is intermediate ().

## FAQ

### What is the CHA2DS2-VASc score?

CHA2DS2-VASc (also written CHADS-VASc or chadsvasc) is a score for the risk of stroke in people with atrial fibrillation (AF). Lip and others published it in 2010 as an update of the older CHADS2 score. Each letter is a risk factor: Congestive heart failure, Hypertension, Age 75 or older (2 points), Diabetes, Stroke (2 points), Vascular disease, Age 65 to 74, and Sex category (female).

### What is a high CHA2DS2-VASc score?

The score runs from 0 to 9, and stroke risk rises with it. The 2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline counts a score of 2 or more in men, or 3 or more in women, as high risk. A clinician weighs the score together with bleeding risk and your preferences.

### Why does being female count as a point?

In the studies, women with AF had a higher stroke risk than men with the same other risk factors. But female sex is a risk modifier: a woman whose only point is her sex has the same low risk as a man with 0 points. That is why the risk group on this page does not count the female point.

### What counts as vascular disease?

A past heart attack (myocardial infarction), peripheral artery disease, or complex plaque in the aorta. In the 2023 guideline, coronary artery disease seen on imaging also counts.

### What is the difference between CHADS2 and CHA2DS2-VASc?

CHADS2 (2001) has 5 items and scores 0 to 6. CHA2DS2-VASc adds vascular disease, age 65 to 74, and female sex, and gives 2 points for age 75 or older. It is better at finding people who are truly at low risk, so most guidelines now use it.

## Sources

- Lip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJGM. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation. Chest. 2010;137(2):263-272. https://doi.org/10.1378/chest.09-1584
- Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation. Circulation. 2024;149(1):e1-e156. https://doi.org/10.1161/CIR.0000000000001193