ASCVD Risk Calculator
Calculate your 10-year risk of atherosclerotic cardiovascular disease (heart attack or stroke) using the ACC/AHA Pooled Cohort Equations.
What is the ASCVD Risk Calculator?
The ASCVD (Atherosclerotic Cardiovascular Disease) Risk Calculator estimates 10-year risk of first heart attack or stroke using the Pooled Cohort Equations. Developed by ACC/AHA, it uses age, sex, race, cholesterol, blood pressure, diabetes, and smoking status. Used in 2013+ cholesterol guidelines for statin therapy decisions. More comprehensive than older Framingham score, includes race-specific equations for better accuracy.
How is ASCVD different from Framingham Risk Score?
ASCVD uses Pooled Cohort Equations from multiple diverse cohorts, includes race (White/Black/Other), predicts hard ASCVD events (MI, stroke, CHD death), recommended by ACC/AHA guidelines since 2013. Framingham uses older data, doesn't account for race, predicts broader CVD. ASCVD generally preferred in US for statin decisions. Both valid; ASCVD may overestimate risk in some low-risk populations but better for diverse populations.
When should statins be considered based on ASCVD risk?
2018 ACC/AHA Guidelines: <5% risk (low): Lifestyle modifications, reassess in 4-6 years. 5-7.5% (borderline): Consider risk enhancers (family history, CAC score), may benefit from moderate-intensity statin. 7.5-20% (intermediate): Moderate-intensity statin recommended. >20% (high): High-intensity statin recommended. Always incorporate shared decision-making with physician. Consider aspirin in select cases.
What are risk enhancers for ASCVD?
Risk enhancers help refine intermediate risk (7.5-20%): Family history of premature ASCVD, persistently elevated LDL >=160 mg/dL, chronic kidney disease, metabolic syndrome, inflammatory conditions (RA, psoriasis), premature menopause, pregnancy complications, high-risk ethnicities (South Asian), elevated biomarkers (hs-CRP, Lp(a), ApoB), ankle-brachial index <0.9. Consider coronary artery calcium (CAC) score if uncertain. Enhancers may tip decision toward statin therapy.
Can I lower my ASCVD risk score?
Modifiable factors: Quit smoking (single biggest impact), lower LDL cholesterol (diet, statins), raise HDL (exercise, weight loss), control blood pressure (DASH diet, weight loss, medication), manage diabetes (A1c <7%). Lifestyle: Mediterranean diet, 150+ min/week moderate exercise, maintain healthy weight, limit alcohol, reduce stress. Even 5-10% risk reduction meaningful. Statins can lower risk 25-50%. Regular monitoring shows progress. Non-modifiable: age, sex, race.