Risk guide

ASCVD 10-year risk: what the Pooled Cohort Equations tell you

The ASCVD Pooled Cohort Equations estimate the probability that you will have a first heart attack or stroke in the next ten years. They are the calculation behind most cholesterol treatment conversations in primary care.

Free ASCVD risk calculator

Estimate your 10-year risk of a first heart attack or stroke with the ACC/AHA Pooled Cohort Equations. No account, no email — the maths runs in your browser and nothing you type is sent anywhere or saved.

years (40–79 for the validated range)

mg/dL

mg/dL

mmHg

What it needs

  • Age (40-79) and sex
  • Race group (the equations are separately calibrated)
  • Total cholesterol and HDL cholesterol
  • Systolic blood pressure, and whether it is treated
  • Diabetes status
  • Current smoking status

How to read the result

Below 5% is low risk; 5-7.4% borderline; 7.5-19.9% intermediate; 20% and above high. The bands exist because they map to how strongly guidelines recommend treatment — an intermediate score is usually the trigger for a risk discussion rather than an automatic prescription.

What moves the number most

Systolic blood pressure and smoking status typically shift the score more than cholesterol alone. Vitals includes an intervention simulator so you can see what stopping smoking or lowering systolic pressure by 10 mmHg would do to your own estimate.

Where it falls short

The equations were derived from US cohorts and are known to over- or under-estimate in some populations. They do not apply under 40 or over 79, and they say nothing about lifetime risk in a young person with very high cholesterol. Vitals runs QRISK3 alongside ASCVD so you can compare rather than rely on one model.

Source

2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk (Goff et al.)

This guide is educational. It is not a diagnosis and does not replace a conversation with a qualified clinician.

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