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ASCVD · ACC/AHA Pooled Cohort

Heart Age QRISK

A calculator of the 10-year risk of a first heart attack or stroke from the ASCVD Pooled Cohort equations (ACC/AHA, 2013). Enter 9 parameters — the model estimates the probability of a cardiovascular event and shows which factors contribute most and what you can actually change about them.

9risk factors 500,000+cohort participants 40–79years ~2 minto fill in

Cardiovascular risk: heart, blood vessels, atherosclerosis

cause of death worldwide — cardiovascular disease

80%

of heart attacks and strokes are potentially preventable by correcting risk factors

7.5%

10-year risk — the threshold at which the ACC/AHA recommends discussing statins

~10%

of adults without CVD already have a 10-year risk of ≥ 20% (high category)

Methodology

How the 10-year ASCVD risk is calculated

The Pooled Cohort Equations are a Cox proportional-hazards model trained on the pooled NHLBI cohorts (over 500,000 person-years of follow-up). Each factor is log- transformed, weighted by a β coefficient for your group (sex × race) and, through the baseline survival S₀, converted into the probability of a first heart attack or stroke over 10 years.

01

ln x

Transformation

Age, cholesterol and blood pressure are converted to a logarithmic scale — the model works with ln(x).
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02

β·x

Weighting

Each factor is multiplied by a β coefficient for your group (sex × race) and summed.
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03

S₀

Baseline survival

The sum is compared with the cohort mean and plugged into the baseline 10-year survival S₀.
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04

%

10-year risk

The result is the probability of a first heart attack or stroke within 10 years, as a percentage.

What ASCVD is and why it matters

ASCVD (atherosclerotic cardiovascular disease) refers to acute vascular events caused by atherosclerosis: a non-fatal myocardial infarction, death from coronary heart disease, and a fatal or non-fatal stroke. The calculator estimates the probability of a first such event over 10 years in a person without established CVD. To see how much the arteries themselves have aged, check the vascular age estimate.

How an event develops

High LDL arrow_forward Arterial plaque arrow_forward Plaque rupture arrow_forward Thrombosis → heart attack / stroke

The nine risk factors in the model

The ACC/AHA equations account for 9 variables. Five of them are modifiable — they respond to lifestyle or medication, while four (age, sex, race) are fixed. The strongest influence on the result is blood pressure.

bloodtype

Total cholesterol

Normal < 200 mg/dL. A high level speeds up the formation of atherosclerotic plaques.

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HDL cholesterol

The "good" cholesterol — the higher, the better. Normal ≥ 40 (men), ≥ 50 (women).

monitor_heart

Systolic BP

The upper blood-pressure number. Normal < 120 mmHg. One of the most influential factors.

smoking_rooms

Smoking

Doubles ASCVD risk. Quitting smoking is the most effective way to lower risk.

water_drop

Diabetes

Doubles the risk of heart attack and stroke through damage to the vascular endothelium.

medication

Blood-pressure treatment

Taking antihypertensives changes how the model interprets systolic pressure.

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Age (40–79)

The heaviest weight in the model. Risk rises non-linearly with age.

Sex

Women have lower risk before menopause; after 55 the gap with men narrows.

groups

Race

African Americans have separate equations; other groups use the equations for white individuals.

10-year ASCVD risk calculator

Take cholesterol and blood pressure from a blood test or your most recent measurement. The model applies to people aged 40–79 without established cardiovascular disease. Fields accept either a dot or a comma as the decimal separator.

1 Demographics

Sex

Age 40–79

years

Race

2 Lipids and blood pressure

Total cholesterol < 200 · mmol/L ×38.7

mg/dL

HDL cholesterol ≥ 40 (m) / 50 (f)

mg/dL

Systolic pressure < 120 · upper number only

mmHg

3 Additional factors

medication Blood-pressure treatment water_drop Diabetes smoking_rooms Smoking

ACC/AHA Pooled Cohort · 10 years

—%

Probability of a first heart attack or stroke within 10 years

—

ACC/AHA 10-year risk scale

0% 7.5% 15% 22.5% ≥30%

Your 10-year risk

—

The probability of a first heart attack or stroke over 10 years, based on your data.

With optimal factors

—

The lowest achievable risk for your sex, age and race (non-modifiable factors).

Contribution of modifiable factors (percentage points of risk)

Red — the factor raises your risk relative to its optimum; green — it lowers (protects) it. The bar length shows how much the factor shifts absolute risk. Age, sex and race are not shown (non-modifiable).

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How to lower your risk: what you can actually change

Below are the factors that raise your risk the most, with evidence-based steps to correct them. Sorted by the size of their contribution. This is educational information, not a substitute for medical advice.

info

The calculator is educational and does not replace consultation with a physician. The Pooled Cohort Equations are validated for ages 40–79 and only for primary prevention (without established CVD). Discuss the result with a cardiologist or general practitioner.

For information only — not medical advice; consult a qualified healthcare provider before making any health decision. The values you enter are used only to calculate your result and are not stored on our servers.

The four ACC/AHA risk categories

Based on the 10-year risk, the ACC/AHA defines four categories with different recommendations:

< 5%

Low risk

Lifestyle changes. Reassess in 4–6 years.

5–7.4%

Borderline

Discuss risk with a physician; assess additional factors.

7.5–19.9%

Intermediate

Discussing statin therapy with a physician is recommended.

≥ 20%

High risk

High-intensity statin therapy; control of all risk factors.

How risk is distributed in the population

Data from the NHLBI cohort studies show how adults without CVD are distributed across levels of 10-year risk. About a third have very low risk, while roughly one in ten is already in the high-risk zone of ≥ 20%.

Distribution of 10-year ASCVD risk in the population

< 2.5%

33.4%

2.5–4.9%

21.0%

5.0–7.4%

12.7%

7.5–9.9%

7.4%

10–14.9%

8.9%

15–19.9%

6.3%

≥ 20%

10.2%

Source: ACC/AHA Pooled Cohort Equations — data from the NHLBI cohort studies, n > 500,000.

When statins are recommended

The ACC/AHA guidelines identify four groups where the benefit of statins is reliably proven:

Established clinical ASCVD (secondary prevention).
Primary hypercholesterolemia: LDL ≥ 190 mg/dL.
Age 40–75, diabetes, LDL 70–189 mg/dL.
Age 40–75, without ASCVD or diabetes, LDL 70–189 mg/dL, 10-year risk ≥ 7.5%.

Intensity	LDL reduction	Drugs and doses
High	≥ 50%	Atorvastatin 40–80 mg · Rosuvastatin 20–40 mg
Moderate	30–49%	Atorvastatin 10–20 mg · Rosuvastatin 5–10 mg · Simvastatin 20–40 mg · Pravastatin 40–80 mg

Prescribing statins is solely a physician's decision, taking into account the full clinical picture, contraindications and the patient's preferences.

Limitations of the method

Age range: the equations are validated only for ages 40–79.
Primary prevention only: not applicable with established CVD or a prior heart attack or stroke.
Ethnic limitations: the data come from white and African American individuals in the US; accuracy is lower for other groups.
Risk of overestimation: several studies have shown the absolute risk to be overstated by 25–115% in modern populations.
Not accounted for: a family history of early CVD, LDL level, hs-CRP, or the coronary artery calcium score.