ASCVD Risk Calculator

Not always. For male patients, age has a consistently positive relationship with 10-Year ASCVD Risk. But the female coefficient set includes an age-squared term (4.884 x ln(age)^2), and depending on the other inputs that squared term can make raising age LOWER the calculated risk over part of the input range -- for example, at total cholesterol 320 mg/dL and HDL 20 mg/dL, risk falls from about 10.8% at age 40 to about 8.3% at age 50 before rising again at older ages. So the direction of age's effect can flip depending on the other risk factors, especially for women -- it is not safe to assume "older is always higher risk" across this calculator's full input range.

No, and the gap is larger than a footnote. This tool implements only the coefficient set the 2013 ACC/AHA guideline publishes for non-Hispanic White adults -- there is no race input, so every patient silently gets the White coefficients. The 2013 guideline's own published example shows the real magnitude of the difference for otherwise-identical risk factors: White women 2.1% vs. African-American women 3.0% 10-year risk, and White men 5.3% vs. African-American men 6.1%. That's large enough to flip a patient across the 7.5% statin-discussion threshold in some cases. Neither coefficient set has been validated for other race/ethnicity groups either. If a patient's race is not well represented by the White coefficient set, use the AHA's 2024 PREVENT risk equations (Circulation 2024) instead -- they're race-free by design, cover ages 30-79, and are the equation set current AHA guidance is moving toward. Adding a second (Black) coefficient set to this specific calculator is tracked as future work, not done in this pass -- see the code comment above the claims list.

7.5% is the threshold the 2013 ACC/AHA guideline uses to recommend a clinician and patient discuss starting statin therapy as part of a broader risk-reduction conversation -- it is not an automatic prescription. Risk under 5% is considered low, 5-7.5% is borderline, 7.5-20% is intermediate, and 20% or higher is high risk, with the statin discussion becoming a stronger recommendation as risk climbs through those bands.

No. The Pooled Cohort Equations are a primary-prevention tool, meaning they estimate first-event risk in people without known atherosclerotic cardiovascular disease. Someone with an existing history of heart attack, stroke, or diagnosed ASCVD needs a secondary-prevention risk assessment instead, which this calculator does not provide.

The Pooled Cohort Equations were derived and validated in cohort studies covering ages 40 through 79, so this calculator restricts the age input to that validated range. Applying the same log-linear coefficients to a 35-year-old or a 90-year-old extrapolates well outside the data the equations were fit to and can produce an unreliable estimate.