ASCVD 10-Year Risk Calculator

What this ASCVD 10-year risk calculator does

This tool estimates your 10-year risk of developing a first atherosclerotic cardiovascular disease (ASCVD) event, such as a heart attack or stroke. It uses your age, cholesterol levels, blood pressure, smoking status, and diabetes status to produce a percentage. That percentage represents the chance that someone with your profile will have a cardiovascular event in the next 10 years, based on large population studies.

The calculator is designed to support—not replace—conversations with your clinician about heart disease prevention, lifestyle changes, and whether to consider medications like statins or blood pressure drugs.

Quick summary

Enter your age, total cholesterol, HDL cholesterol, systolic blood pressure, and whether you take blood pressure medication, smoke, or have diabetes. The calculator returns a 10-year ASCVD risk percentage. Lower percentages indicate a lower estimated chance of heart attack or stroke over the next decade, while higher percentages suggest the need for more intensive prevention strategies under medical guidance.

What is ASCVD and 10-year risk?

Atherosclerotic cardiovascular disease (ASCVD) refers to conditions caused by the buildup of fatty deposits (plaques) in your arteries. This includes coronary heart disease (such as heart attack), stroke, and peripheral arterial disease. Over time, plaque can narrow or block blood vessels or suddenly rupture, leading to serious events.

10-year ASCVD risk is an estimate of the probability that you will have your first major cardiovascular event in the next 10 years. It does not predict exactly what will happen to you as an individual. Instead, it uses patterns observed in large groups of people with similar risk factors.

The most widely used method in the United States is based on the 2013 American College of Cardiology (ACC) and American Heart Association (AHA) Pooled Cohort Equations. These equations were derived from long-term studies following tens of thousands of adults and observing who did and did not develop cardiovascular events.

Inputs used in the ASCVD 10-year risk calculator

The calculator uses several key risk factors that have been shown to influence cardiovascular risk. Each factor slightly raises or lowers the estimated probability:

• Age (years) – Risk increases steadily with age because plaque buildup and vessel stiffening accumulate over time.
• Total cholesterol (mg/dL) – Higher total cholesterol generally reflects more circulating fats that can contribute to plaque.
• HDL cholesterol (mg/dL) – Often called “good” cholesterol. Higher HDL levels are usually protective and associated with lower risk.
• Systolic blood pressure (mmHg) – The top blood pressure number. Higher systolic pressure places more strain on artery walls and is linked to higher risk.
• On blood pressure medication (yes/no) – Indicates whether your blood pressure is high enough to require treatment and affects how blood pressure relates to risk.
• Current smoker (yes/no) – Smoking damages blood vessels, promotes plaque formation, and substantially raises cardiovascular risk.
• Diabetes (yes/no) – Diabetes accelerates atherosclerosis and is a major independent risk factor for heart attack and stroke.

These factors are combined mathematically to produce a single 10-year risk percentage. No single input determines your outcome by itself; instead, the calculator looks at the overall pattern.

How the ASCVD risk percentage is calculated

The Pooled Cohort Equations use a statistical method called Cox proportional hazards regression (a type of survival analysis closely related to logistic regression). In simple terms, each risk factor is transformed using logarithms, multiplied by a coefficient that reflects its importance, and then all the pieces are added together. This sum is often called the linear predictor.

The linear predictor is then plugged into an exponential function to convert it into a probability between 0 and 1 (0% to 100%). The exact coefficients and baseline hazard values differ for men and women and for different race groups. The general structure for the 10-year risk P can be represented as:

Where:

• S(0) is the baseline 10-year survival probability for a reference group with average risk.
• L is your individual linear predictor (a sum of your risk factors multiplied by their coefficients).
• Lmean is the average linear predictor in the derivation cohort.

While the underlying math is complex, the main idea is straightforward: each risk factor pushes your estimated risk up or down relative to an average person of your sex and race. The calculator automates this process for you.

How to use this calculator

1. Gather your recent numbers. Use your most recent blood test for total cholesterol and HDL cholesterol, and a reliable blood pressure reading (ideally from a clinic or home monitor). Values more than a year old may not accurately reflect your current risk.
2. Enter your age in years. The Pooled Cohort Equations were developed mainly for adults between about 40 and 79 years of age. Results outside this range may be less reliable.
3. Enter total and HDL cholesterol in mg/dL. These units are standard in the United States. If your results are in mmol/L, they need to be converted before use.
4. Enter systolic blood pressure (the top number) in mmHg. For example, if your blood pressure is 130/80, enter 130.
5. Indicate if you take blood pressure medication. Check this if your clinician has prescribed medication specifically to treat high blood pressure.
6. Indicate if you currently smoke. Mark “smoker” if you use cigarettes regularly now. Past smoking that has fully stopped is usually entered as non-smoker for this calculator, but discuss nuances with your clinician.
7. Indicate if you have diabetes. This usually refers to diagnosed type 1 or type 2 diabetes. If you have prediabetes only, discuss interpretation with your clinician.
8. Run the calculation. Select the button to estimate risk and review the 10-year risk percentage that appears.

Interpreting your ASCVD 10-year risk result

The output is a percentage such as 3%, 8%, or 22%. This means that, in a group of 100 people with the same risk profile as yours, approximately that many would be expected to have a first cardiovascular event over the next 10 years.

Clinical guidelines commonly use approximate risk categories like:

• Low risk: < 5% 10-year risk
• Borderline risk: 5% to < 7.5%
• Intermediate risk: 7.5% to < 20%
• High risk: ≥ 20%

How these ranges are used can vary by country and guideline, but they offer a rough framework:

• Low risk: Emphasis is typically on maintaining healthy habits: not smoking, regular physical activity, balanced diet, weight management, and blood pressure monitoring.
• Borderline risk: Clinicians may focus on lifestyle optimization and consider medications if specific risk-enhancing factors are present (for example, strong family history of early heart disease).
• Intermediate risk: Many people in this range are candidates for preventive medications such as statins, in addition to lifestyle changes, depending on overall clinical judgment.
• High risk: More intensive risk-reduction strategies, including medications and closer follow-up, are often recommended, again tailored to the individual.

Your personal situation, preferences, and other conditions matter. A 65-year-old with a risk of 8% and multiple other health problems may be managed differently than a 45-year-old with the same numeric risk but few comorbidities. The calculator is a starting point for shared decision-making, not a final verdict.

Worked example

To see how different factors interact, consider this example of an individual using the calculator:

Example person:

• Age: 55 years
• Total cholesterol: 220 mg/dL
• HDL cholesterol: 45 mg/dL
• Systolic blood pressure: 135 mmHg
• On blood pressure medication: Yes
• Current smoker: No
• Diabetes: No

When these values are entered, the calculator might return an estimated 10-year ASCVD risk in the intermediate range (for example, around 8–12%, exact value depends on sex and race). This suggests that, in a group of 100 similar people, roughly 8 to 12 might have a first cardiovascular event in 10 years.

How this might guide a discussion with a clinician:

• Because the risk is not low, the clinician might review lifestyle habits: diet quality, physical activity, weight, alcohol use, and stress management.
• They may consider whether the current blood pressure treatment is adequate and whether further adjustments are needed to reach target blood pressure.
• They might discuss starting or continuing a statin medication to reduce cholesterol and overall ASCVD risk, taking into account potential benefits, side effects, and patient preferences.

Now imagine that the same person also smokes and has diabetes. All else equal, the estimated 10-year risk would increase substantially, often moving into a higher risk category. This illustrates how risk factors compound each other rather than acting in isolation.

How this ASCVD 10-year risk estimate compares to other approaches

There are multiple ways to assess cardiovascular risk. The Pooled Cohort Equations focus on 10-year risk of a first ASCVD event and are widely used in U.S. guidelines. Other tools and concepts include lifetime risk estimates and different risk calculators derived from alternative cohorts.

Other risk scores, such as Framingham-based calculators, use slightly different inputs and equations but serve a similar purpose: estimating probability of cardiovascular events. Estimates from different tools will not always match exactly, because they are based on different study populations and modeling choices.

Limitations and assumptions

No risk calculator can perfectly predict who will or will not have a heart attack or stroke. Important limitations and assumptions of this ASCVD 10-year risk estimate include:

• Population-based model: The equations are derived from large groups of people. They work best for people similar to those study populations and may be less accurate for others.
• Age range: The Pooled Cohort Equations were primarily developed for adults roughly 40–79 years old without established ASCVD. Results outside this age range, or in people with known cardiovascular disease, should be interpreted with extra caution.
• Specific risk factors only: The calculator uses a limited set of variables (age, cholesterol, blood pressure, smoking, diabetes). It does not account for all possible influences, such as strong family history, kidney disease, inflammatory conditions, socioeconomic factors, or detailed diet and fitness patterns.
• Baseline assumptions: The baseline risks are estimated from historical cohorts. Changes over time in preventive care, treatments, and population health can affect how well those historical patterns apply to today.
• Race and sex differences: In clinical practice, different equations are applied for different race and sex groups. Implementation details can vary by calculator and may not fully capture the complexity of individual identity and background.
• Measurement error: Inaccurate or out-of-date cholesterol or blood pressure values can substantially distort the result. Always interpret the number in the context of current, reliable measurements.

Because of these limitations, the risk percentage should always be seen as an estimate with some uncertainty, not an exact forecast.

Medical disclaimer and appropriate use

This calculator is provided for general educational and informational purposes only. It does not provide medical advice, diagnosis, or treatment, and it is not a substitute for evaluation and recommendations from a qualified healthcare professional.

• Do not start, stop, or change any medications based solely on this calculator.
• Do not ignore or delay seeking professional medical advice because of a result shown here.
• If you are concerned about your heart or stroke risk, discuss your numbers, symptoms, and questions with your clinician.

Only a healthcare professional who knows your full medical history, examination findings, and test results can provide personalized guidance about preventing or treating cardiovascular disease.

Sources and context

The risk estimation approach used in this tool is based on the ACC/AHA Pooled Cohort Equations for estimation of 10-year risk of a first ASCVD event (2013). These equations were developed using data from large U.S. cohort studies and underpin many modern prevention guidelines. However, specific thresholds and treatment decisions vary between countries and over time as evidence evolves.

For individualized interpretation of your result, and for the most current recommendations, always consult a healthcare professional familiar with current cardiovascular prevention guidelines in your region.