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ASCVD Risk Calculator (Pooled Cohort Equations)

10-year risk of a first heart attack or stroke from the 2013 ACC/AHA Pooled Cohort Equations, in mg/dL or mmol/L.

For healthcare professionals and students. Check results against your local protocols and clinical judgement; this tool does not give medical advice.
years
The equations cover ages 40–79.
Sex
mg/dL
mmHg
10-year ASCVD risk (Pooled Cohort Equations)2.1%Low risk (under 5%) — 2018 AHA/ACC cholesterol guideline category
57.520030%+ you
Equation
Female, White or other
Individual sum
−29.677
Risk
1 − 0.9665^exp(sum + 29.18)

Goff DC Jr et al., 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk, Circulation 2014;129(suppl 2):S49–S73 (equation coefficients and worked example). Categories: Grundy SM et al., 2018 AHA/ACC cholesterol guideline, Circulation 2019;139:e1082–e1143. For people without known ASCVD and LDL-C below 190 mg/dL; it does not replace a full risk discussion.

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ASCVD risk calculator using the Pooled Cohort Equations

For healthcare professionals and students. Check results against your local protocols and clinical judgement; this tool does not give medical advice.

This ASCVD risk calculator estimates the 10-year risk of a first atherosclerotic cardiovascular disease event — coronary heart disease death, non-fatal heart attack, or fatal or non-fatal stroke — with the Pooled Cohort Equations (PCE) from the 2013 ACC/AHA risk assessment guideline. Enter age, sex, total and HDL cholesterol (mg/dL or mmol/L), systolic blood pressure, blood pressure treatment, diabetes and smoking, and it shows the percentage risk, the 2018 guideline risk category, and every term of the equation.

The equations apply to adults aged 40–79 without known cardiovascular disease. The calculation runs in your browser and nothing is saved.

How to use the ASCVD Risk Calculator

  1. Enter the age (40–79) and choose the sex and equation set.
  2. Enter total and HDL cholesterol and pick mg/dL or mmol/L.
  3. Enter the systolic blood pressure and tick blood pressure treatment, diabetes and current smoking if they apply.
  4. Read the 10-year risk, the category and the position on the bar.
  5. Open the working rows to see the individual sum and the survival equation, and read any warnings.

ASCVD Risk Calculator features

Published coefficients

All four sex and race equations from the 2013 guideline, checked against its worked example.

mg/dL or mmol/L

Cholesterol in either unit; mmol/L is converted with 1 mmol/L = 38.67 mg/dL.

Guideline categories

Low (under 5%), borderline (5–7.4%), intermediate (7.5–19.9%) and high (20% or more), from the 2018 AHA/ACC guideline.

Transparent maths

Shows each non-zero term, the individual sum, the baseline survival and the population mean.

Range checks

Refuses ages outside 40–79 and warns when cholesterol or blood pressure fall outside the estimator’s accepted ranges.

How the Pooled Cohort Equations work

From 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. Each sex and race group has its own coefficients for the natural logarithms of age, total cholesterol, HDL cholesterol and systolic pressure (treated or untreated), with interaction terms, smoking and diabetes. The products are added to give an individual sum, and 10-year risk = 1 − S₁₀^exp(individual sum − group mean), where S₁₀ is the group’s baseline survival.

The guideline’s own example — age 55, total cholesterol 213 mg/dL, HDL 50 mg/dL, untreated systolic pressure 120 mmHg, non-smoker, no diabetes — gives 2.1% for a White woman, 3.0% for an African American woman, 5.3% for a White man and 6.1% for an African American man. This calculator gives 2.1%, 3.0% and 6.1% for the first, second and fourth, and 5.4% for the White man: worked from the published coefficients without rounding along the way, that risk is 5.38%. An independent open-source implementation (the MIT-licensed PooledCohort R package) gets the same 5.4% in its own test of this example. The self-test checks all four.

GroupBaseline survival S₁₀Group mean
Women, White or other0.9665−29.18
Women, African American0.953386.61
Men, White or other0.914461.18
Men, African American0.895419.54

Risk categories and what they are for

The 2018 AHA/ACC cholesterol guideline (Grundy SM et al., Circulation 2019;139:e1082–e1143) groups 10-year risk as low (under 5%), borderline (5% to under 7.5%), intermediate (7.5% to under 20%) and high (20% or more), and uses the category to start a clinician–patient risk discussion together with risk-enhancing factors and, in selected cases, coronary artery calcium. The guideline does not apply the equations to people with clinical ASCVD, LDL cholesterol of 190 mg/dL or more, or adults with diabetes aged 40–75 in the same way, so read its recommendations before acting on a number.

Not included here: the AHA PREVENT equations published in 2023 (Khan SS et al., Circulation 2024;149:430–449), which drop race, add kidney function and estimate 10- and 30-year risk from age 30. Their coefficients sit in the paper’s supplementary appendix, which could not be checked against the primary source for this page, so they are not implemented; use the AHA’s own PREVENT calculator for those estimates.

South Asian, Indian and other populations

The cohorts behind the equations were White and African American adults in the US. The 2013 guideline suggests using the White equations for other groups, accepting that they may overestimate risk in some East Asian and Hispanic populations and underestimate it in others. The 2018 guideline lists South Asian ancestry (people from India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan and the Maldives) as a risk-enhancing factor, because risk in these groups tends to be underestimated. If you search for an ASCVD risk calculator for Indians, treat the PCE value as a probable underestimate and weigh it with family history, lipoprotein(a), metabolic syndrome and other enhancers.

ASCVD Risk Calculator FAQ

How is 10-year ASCVD risk calculated?

With the Pooled Cohort Equations: logarithms of age, cholesterol and blood pressure, multiplied by coefficients for the person’s sex and race group and summed, then converted to risk with 1 − baseline survival^exp(sum − mean). The ASCVD risk calculator above shows each step.

What age range does the ASCVD calculator cover?

40 to 79 years. The equations were not derived outside that range, so the tool refuses other ages rather than extrapolating.

What ASCVD risk score is considered high?

In the 2018 AHA/ACC guideline, 20% or more over 10 years is high risk, 7.5% to under 20% intermediate, 5% to under 7.5% borderline and under 5% low.

Can I enter cholesterol in mmol/L?

Yes. Choose mmol/L; values are converted with 1 mmol/L = 38.67 mg/dL before the equations, which were built in mg/dL. The LDL calculator uses the same factor.

Does the ASCVD calculator include PREVENT?

No. PREVENT (2023) is a separate set of equations; this page explains why it is not implemented here and links the paper.

Is the PCE accurate for Indians and South Asians?

It tends to underestimate risk in South Asian people, which is why the 2018 guideline counts South Asian ancestry as a risk-enhancing factor.

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