Heart Disease Risk Calculator
Calculate your 10-year cardiovascular disease (ASCVD) risk using the Framingham/ASCVD risk score. Includes heart age calculation and personalized recommendations.
Medical Disclaimer: This calculator estimates 10-year cardiovascular disease risk using established algorithms. It is for educational purposes only and does not replace professional medical evaluation. Discuss results with your healthcare provider.
How to Get Your Numbers
To complete this calculator, you need results from a lipid panel blood test and a blood pressure reading:
- • Lipid panel: Fasting blood test from your doctor (Total and HDL cholesterol)
- • Blood pressure: Recent reading from doctor visit or home monitor
- • Request these at your next checkup or from a pharmacy/clinic
Related Calculators
About This Calculator
Are you at risk for heart disease? The Heart Disease Risk Calculator estimates your 10-year chance of a heart attack or stroke using the same ASCVD (Atherosclerotic Cardiovascular Disease) risk equation your doctor uses - but here's the uncomfortable truth most calculators hide: cardiovascular disease kills more Americans than all cancers combined, yet 80% of it is preventable.
Every 34 seconds, someone in America dies from cardiovascular disease. That's over 900,000 deaths annually - more than cancer, accidents, and respiratory disease put together. The cruelest part? Most victims had no idea they were at risk until it was too late. Nearly half of all Americans have at least one of the three key CVD risk factors (high blood pressure, high cholesterol, or smoking) and many don't know it.
This calculator uses the ASCVD risk equation refined over decades from the famous Framingham Heart Study that began in 1948. In 2023, the AHA introduced the new PREVENT model (Predicting Risk of cardiovascular disease EVENTs) that adds kidney function, A1c levels, and social determinants of health - but the core insight remains: your risk is driven by modifiable factors you can change today.
Your "heart age" may shock you. A 50-year-old with high cholesterol, high blood pressure, and diabetes can have the cardiovascular system of a 70-year-old. But here's the empowering news: the 2025 American Heart Association research confirms that every risk factor you address can reverse years of damage. Within two to three years of quitting smoking alone, the risk of death from heart disease drops by 36 percent.
Whether you're asking "What is my heart disease risk?" or "How can I prevent a heart attack?", this calculator gives you your personal 10-year risk score and actionable steps to improve it.
Disclaimer: This calculator is for educational purposes only. It does not diagnose heart disease. Please consult a healthcare provider for proper risk assessment and treatment recommendations.
How to Use the Heart Disease Risk Calculator
- 1**Enter basic demographics**: Age (40-79 for validated results), biological sex, and race/ethnicity. These are non-modifiable but affect baseline risk.
- 2**Enter cholesterol levels**: Total cholesterol and HDL ("good") cholesterol from a recent lipid panel blood test. If you don't have recent numbers, get tested - you cannot accurately assess risk without them.
- 3**Enter blood pressure**: Your systolic (top number) reading and whether you take BP medications. Use an average of multiple readings for accuracy.
- 4**Answer health questions**: Diabetes and smoking status significantly impact your calculated risk. Be honest - underreporting gives false reassurance.
- 5**Review your 10-year risk**: See your percentage chance of heart attack or stroke in the next decade. Understand what the risk categories mean for your health decisions.
- 6**Note your heart age**: Compare your cardiovascular health to your chronological age - this can be a powerful motivator for change.
- 7**Identify modifiable factors**: Review which risk factors you can change through lifestyle modifications or medical treatment.
- 8**Create an action plan**: Use your results to have an informed conversation with your healthcare provider about prevention strategies.
Understanding the 10-Year Risk Score
Your 10-year ASCVD risk represents your probability of having a cardiovascular "event" (heart attack, stroke, or related death) in the next decade.
Risk Categories
| 10-Year Risk | Category | What It Means |
|---|---|---|
| < 5% | Low Risk | Heart-healthy lifestyle recommended |
| 5-7.4% | Borderline | Consider risk-enhancing factors; lifestyle focus |
| 7.5-19.9% | Intermediate | Discussion with doctor about statins; aggressive lifestyle |
| 20%+ | High Risk | Statin therapy strongly recommended; intensive management |
What the Percentage Means
A 15% 10-year risk means: Of 100 people with your exact profile, approximately 15 will have a heart attack or stroke within 10 years.
2023 AHA PREVENT Model
The AHA's new PREVENT (Predicting Risk of cardiovascular disease EVENTs) model improves on older equations by adding:
- Kidney function (eGFR, urine albumin)
- Hemoglobin A1c for diabetics
- Social determinants of health
- 30-year risk prediction (not just 10-year)
This calculator uses the validated ASCVD equation, which remains the clinical standard for risk assessment.
The Modifiable vs. Non-Modifiable Factors
Some risk factors you cannot change. Others you can dramatically improve:
Non-Modifiable Risk Factors
| Factor | Impact | Why It Matters |
|---|---|---|
| Age | Risk doubles each decade after 55 | Time allows plaque accumulation |
| Sex | Men at higher risk until age 55 | Estrogen provides some protection |
| Race | African Americans have higher risk | Genetic and social factors |
| Family history | Doubles risk if parent had early CVD | Shared genetics and environment |
Modifiable Risk Factors
| Factor | Risk Reduction | What to Do |
|---|---|---|
| Smoking | 50% reduction within 1 year of quitting | Single biggest modifiable factor |
| LDL Cholesterol | 20-25% per 39 mg/dL reduction | Statins, diet, exercise |
| Blood Pressure | 20% per 10 mmHg reduction | DASH diet, exercise, medication |
| Diabetes | 2-4x increased risk | A1c control, weight loss |
| Obesity | Risk increases with BMI | Diet, exercise, sometimes surgery |
| Physical Inactivity | 30-40% reduction with exercise | 150 min/week moderate activity |
The Power of Multiple Changes
Addressing multiple factors has multiplicative effects:
| Intervention Combo | Total Risk Reduction |
|---|---|
| Quit smoking alone | ~50% |
| Quit smoking + lower LDL | ~65% |
| Quit smoking + lower LDL + control BP | ~75% |
| All of above + control diabetes | ~80-85% |
Heart Age: What Your Cardiovascular System Reveals
Your "heart age" compares your cardiovascular health to population averages:
What Heart Age Means
| Your Age | Your Risk | Heart Age | Interpretation |
|---|---|---|---|
| 50 | 5% | 50 | Actual age = heart age (optimal) |
| 50 | 10% | 60 | Heart aging 10 years faster |
| 50 | 15% | 68 | Significant premature aging |
| 50 | 3% | 45 | Better than average cardiovascular health |
Factors That Age Your Heart Faster
- Smoking: Adds 5-10 years to heart age
- Uncontrolled hypertension: Adds 3-8 years
- High LDL cholesterol: Adds 2-5 years
- Diabetes: Adds 5-15 years
- Obesity: Adds 2-5 years
- Sedentary lifestyle: Adds 2-4 years
Reversing Heart Age
The good news: lifestyle changes can reverse heart age within months to years:
| Change | Heart Age Reduction |
|---|---|
| Quit smoking (1 year) | 3-5 years younger |
| Blood pressure to normal | 2-4 years younger |
| LDL cholesterol controlled | 1-3 years younger |
| Regular exercise (6 months) | 2-3 years younger |
| Weight loss (10% body weight) | 1-2 years younger |
The Statin Decision: When Numbers Trigger Medication
Statin therapy recommendations are directly tied to your risk score:
2018 AHA/ACC Statin Guidelines
| Risk Level | LDL Level | Recommendation |
|---|---|---|
| Low (<5%) | Any | Lifestyle only |
| Borderline (5-7.4%) | >100 mg/dL | Consider if risk enhancers present |
| Intermediate (7.5-19.9%) | >70 mg/dL | Moderate-intensity statin |
| High (20%+) | Any | High-intensity statin |
Risk-Enhancing Factors
These tip the scale toward medication in borderline cases:
- Family history of premature CVD
- LDL persistently >160 mg/dL
- Metabolic syndrome
- Chronic kidney disease
- Chronic inflammatory conditions (RA, psoriasis)
- South Asian ancestry
- Elevated lipoprotein(a)
- Elevated apoB
Coronary Artery Calcium (CAC) Score
For intermediate-risk patients, a CAC scan can refine the decision:
| CAC Score | Interpretation | Action |
|---|---|---|
| 0 | Very low risk | May defer statin |
| 1-99 | Plaque present | Favors statin therapy |
| 100+ | Significant plaque | Strong indication for statin |
NNT: Number Needed to Treat
The NNT tells you how many people need treatment to prevent one event:
| Your Risk | Statin NNT (5 years) | Meaning |
|---|---|---|
| 5% | ~100 | 1 in 100 treated will benefit |
| 10% | ~50 | 1 in 50 will benefit |
| 20% | ~25 | 1 in 25 will benefit |
Life's Essential 8: The AHA's Framework for Heart Health
The American Heart Association's Life's Essential 8 provides a comprehensive framework for optimal cardiovascular health - and unfortunately, fewer than 1% of Americans have all eight factors optimized.
The 8 Key Metrics
| Factor | Optimal Target | Why It Matters |
|---|---|---|
| Diet | DASH or Mediterranean pattern | Directly affects cholesterol, BP, weight |
| Physical Activity | 150 min moderate/week | Improves all other metrics |
| Nicotine Exposure | Never or quit 5+ years | Single biggest modifiable factor |
| Sleep | 7-9 hours/night | Affects BP, weight, glucose |
| Body Mass Index | 18.5-24.9 kg/m² | Risk increases with BMI above 25 |
| Blood Lipids | Non-HDL <130 mg/dL | Direct driver of atherosclerosis |
| Blood Glucose | A1c <5.7% (fasting <100) | Diabetes 2-4x increases risk |
| Blood Pressure | <120/80 mmHg | Most prevalent risk factor |
How to Score Yourself
The AHA assigns 0-100 points for each metric. Your total score predicts cardiovascular outcomes:
| Total Score | Category | 10-Year CVD Risk |
|---|---|---|
| 80-100 | High CV Health | Very Low |
| 50-79 | Moderate CV Health | Moderate |
| 0-49 | Low CV Health | Elevated |
2025 Research Update
The latest research confirms that improving just one category from "poor" to "ideal" can reduce heart disease risk by 20%. The good news: it's never too late to start. Even adults in their 60s and 70s see significant risk reduction with lifestyle improvements.
Sleep: The New Essential
The 2022 update added sleep as the 8th essential, based on research showing:
- Short sleep (<6 hours) increases CVD risk by 20%
- Poor sleep quality elevates inflammation markers
- Sleep apnea dramatically increases heart disease risk
- Weekend "catch-up" sleep may help reduce arterial calcium buildup
Heart Disease Risk: Women vs Men - Critical Differences
Heart disease is often considered a "man's disease" - a dangerous misconception that contributes to women receiving less aggressive treatment and worse outcomes.
Key Statistics by Gender
| Metric | Women | Men |
|---|---|---|
| Average age of first heart attack | 72 years | 65 years |
| Lifetime risk of heart disease | 1 in 3 | 1 in 2 |
| Mortality after heart attack | Higher | Lower |
| Recognition of symptoms | Often delayed | Usually faster |
Why Women's Risk Is Underestimated
- Calculator limitations: Most risk equations were developed primarily from male-dominated studies
- Symptom differences: Women often experience atypical symptoms (fatigue, nausea, jaw pain) rather than classic chest pain
- Smaller arteries: Women have smaller coronary arteries, making blockages more dangerous and harder to treat
- Microvascular disease: Women are more likely to have disease in small vessels that doesn't show on standard tests
Women-Specific Risk Factors
| Risk Factor | Impact | What to Know |
|---|---|---|
| Preeclampsia | 2x lifetime CVD risk | Even if pregnancy was decades ago |
| Gestational diabetes | 2-7x lifetime diabetes risk | Screen annually after pregnancy |
| PCOS | 2x CVD risk | Metabolic effects persist |
| Early menopause | 1.5x CVD risk | Loss of estrogen protection |
| Hormone therapy | Complex | Timing matters (early is safer) |
Post-Menopause Changes
After menopause, women's cardiovascular risk profile changes dramatically:
- LDL cholesterol levels often exceed men's by age 65
- Blood pressure tends to rise faster than in men
- Weight gain shifts to abdominal (more dangerous) distribution
- Protective effects of estrogen are lost
The Bottom Line for Women
Don't assume you're protected because you're female. Advocate for comprehensive cardiac testing, know your risk factors, and don't dismiss atypical symptoms.
Hidden Risk Factors: Beyond the Basics
Standard risk calculators capture the major factors, but emerging research reveals additional predictors that your doctor may not mention.
Inflammatory Markers
| Marker | What It Measures | Risk Implication |
|---|---|---|
| hs-CRP | Systemic inflammation | >3.0 mg/L = high CVD risk |
| Lp(a) | Genetic cholesterol particle | >50 mg/dL = 2-3x risk (affects 20% of people) |
| ApoB | Atherogenic particles | Better predictor than LDL in some cases |
| Homocysteine | Amino acid metabolism | Elevated levels damage blood vessels |
Chronic Inflammatory Conditions
These conditions significantly increase cardiovascular risk but aren't in standard calculators:
| Condition | Additional Risk | Why |
|---|---|---|
| Rheumatoid arthritis | 50-100% higher | Chronic inflammation accelerates atherosclerosis |
| Psoriasis | 50% higher | Systemic inflammatory effects |
| Lupus | 2-10x higher | Autoimmune damage to vessels |
| HIV (treated) | 50-100% higher | Chronic immune activation |
Psychosocial Factors
The AHA's new PREVENT model includes social determinants of health:
| Factor | Impact | Mechanism |
|---|---|---|
| Chronic stress | 40% higher risk | Elevated cortisol, inflammation |
| Depression | 2x risk | Behavioral and biological effects |
| Social isolation | 29% higher risk | Comparable to smoking 15 cigarettes/day |
| Low socioeconomic status | 1.5-2x risk | Access, chronic stress, environment |
Metabolic Risk Factors
| Factor | What It Means | Action |
|---|---|---|
| Metabolic syndrome | Cluster of 3+ risk factors | Aggressive lifestyle intervention |
| Non-alcoholic fatty liver | Liver stores excess fat | Associated with 2x CVD risk |
| Insulin resistance | Pre-diabetes state | Lifestyle changes can reverse it |
| Elevated triglycerides | >150 mg/dL | Diet modification, possible medication |
Should You Get Additional Testing?
Consider asking your doctor about hs-CRP or Lp(a) testing if:
- Family history of early heart disease with "normal" cholesterol
- Intermediate risk score (7.5-19.9%)
- Autoimmune or chronic inflammatory conditions
- You want to refine your statin decision
How to Lower Heart Disease Risk: Evidence-Based Strategies
The most empowering truth about cardiovascular disease: 80% is preventable through lifestyle modification. Here's what actually works, ranked by impact.
Tier 1: Highest Impact Changes
| Intervention | Risk Reduction | Timeframe |
|---|---|---|
| Quit smoking | 50% reduction | Benefit starts within days |
| Control blood pressure | 20% per 10 mmHg drop | Weeks to months |
| Lower LDL cholesterol | 20-25% per 39 mg/dL drop | Months |
| Manage diabetes | Variable but significant | Ongoing |
The Portfolio Diet: 2025's Rising Star
Research shows the Portfolio Diet may reduce heart disease death risk by 18% and delay cardiovascular events by up to 13 years. Key components:
| Food Group | Daily Target | Effect |
|---|---|---|
| Nuts | 1 oz (handful) | Lowers LDL, healthy fats |
| Plant sterols | 2g (fortified foods) | Blocks cholesterol absorption |
| Soluble fiber | 10-25g (oats, beans) | Reduces LDL by 5-10% |
| Soy protein | 25g | Modest LDL reduction |
Exercise: How Much Is Enough?
| Activity Level | Minutes/Week | CVD Risk Reduction |
|---|---|---|
| Sedentary | 0 | Baseline (highest risk) |
| Light | 75-150 | 14% reduction |
| Moderate | 150-300 | 20-25% reduction |
| High | 300+ | 30-40% reduction |
Even small amounts help: Just 15 minutes of daily walking reduces heart attack risk.
Stress Management That Works
| Technique | Evidence Level | What to Do |
|---|---|---|
| Meditation | Strong | 10-20 minutes daily |
| Social connection | Strong | Regular meaningful interactions |
| Nature exposure | Moderate | 120+ minutes/week in green spaces |
| Breathing exercises | Moderate | Box breathing during stress |
Creating a Sustainable Plan
The key is starting small and building habits:
- Week 1-2: Focus on one change (e.g., daily walking)
- Week 3-4: Add a second change (e.g., reduce processed foods)
- Month 2: Introduce third change (e.g., stress management)
- Month 3+: Continue building, get progress check-up
ASCVD vs PREVENT vs Framingham: Which Calculator Is Best?
Multiple heart disease risk calculators exist, each with strengths and limitations. Understanding the differences helps you interpret your results.
Calculator Comparison
| Calculator | Developed | Best For | Limitations |
|---|---|---|---|
| Framingham | 1998 | General population baseline | May overestimate in low-risk groups |
| ASCVD (PCE) | 2013 | Clinical decision-making | Less accurate for some ethnicities |
| PREVENT | 2023 | Comprehensive assessment | Requires more lab values |
| SCORE2 | 2021 | European populations | Not validated for US |
| MESA | 2015 | Adds CAC score | Requires CT scan |
The 2023 PREVENT Model: What's New
The AHA's PREVENT equations represent a significant improvement:
| Feature | Old ASCVD | New PREVENT |
|---|---|---|
| Age range | 40-79 | 30-79 |
| Time horizon | 10-year only | 10-year AND 30-year |
| Kidney function | Not included | eGFR, urine albumin |
| Diabetes refinement | Yes/No only | Includes A1c level |
| Social factors | Not included | Social Deprivation Index |
| Heart failure | Not included | Included as outcome |
Which Calculator Should You Use?
For most adults (40-79): ASCVD (Pooled Cohort Equations) remains the clinical standard For younger adults (30-39): PREVENT offers 30-year risk estimates For diabetes: PREVENT with A1c provides better calibration For kidney disease: PREVENT includes eGFR for better accuracy For intermediate risk: Consider adding CAC score (MESA calculator)
Important Limitations of ALL Calculators
- Age dominance: Older adults will almost always have "high" risk even with optimal factors
- Family history: Most calculators don't include this directly
- Ethnicity: Validated primarily in White and Black Americans
- Individual variation: Population-based estimates don't predict your specific outcome
Pro Tip: Use Multiple Calculators
If your ASCVD risk is 7.5-15% (borderline/intermediate), consider:
- Getting a CAC scan for additional risk stratification
- Using PREVENT if you have kidney disease or diabetes
- Discussing risk-enhancing factors with your doctor
Interpreting Your Results: From Numbers to Action
A risk score is meaningless without action. Here's how to translate your results into a concrete plan.
Risk Category Action Plans
Low Risk (<5%)
| Focus Area | Action | Timeline |
|---|---|---|
| Lifestyle maintenance | Continue healthy habits | Ongoing |
| Monitoring | Recheck risk every 5 years | 5 years |
| Prevention | Address any single risk factor | As needed |
Borderline Risk (5-7.4%)
| Focus Area | Action | Timeline |
|---|---|---|
| Risk discussion | Talk to doctor about enhancers | Within month |
| Lifestyle intensification | Focus on diet and exercise | Immediate |
| Consider CAC scan | If decision is unclear | Discuss with doctor |
| Recheck | Annual risk reassessment | 1 year |
Intermediate Risk (7.5-19.9%)
| Focus Area | Action | Timeline |
|---|---|---|
| Statin discussion | Moderate-intensity may be indicated | Within month |
| Aggressive lifestyle | Diet, exercise, weight loss | Immediate |
| Blood pressure | Target <130/80 | Within months |
| Lipid monitoring | Repeat panel in 6-12 weeks | If starting statin |
High Risk (20%+)
| Focus Area | Action | Timeline |
|---|---|---|
| Statin therapy | High-intensity recommended | Immediate |
| Blood pressure | Target <130/80, possibly lower | Immediate |
| Diabetes management | Target A1c <7% | Ongoing |
| Aspirin discussion | May be indicated (discuss with doctor) | Within month |
| Frequent monitoring | Risk factors every 3-6 months | Ongoing |
Tracking Progress
| Metric | How Often | Goal |
|---|---|---|
| Blood pressure | Weekly (home) | <130/80 |
| Weight | Weekly | BMI 18.5-24.9 |
| Physical activity | Daily | 150 min/week |
| Lipid panel | Every 6-12 months | LDL per target |
| A1c (if diabetic) | Every 3 months | <7% |
When to Reassess Your Risk Score
Recalculate after:
- Major lifestyle changes (sustained 6+ months)
- Starting or stopping medications
- Significant weight loss/gain
- Smoking cessation (at 1 year)
- New diabetes diagnosis
- Annually if intermediate/high risk
Pro Tips
- 💡Get a lipid panel blood test at least every 5 years (annually if you have risk factors). You need actual numbers, not guesses - estimated values make risk calculations unreliable.
- 💡Track your blood pressure at home regularly. Single readings can be misleading due to "white coat hypertension" - average multiple readings taken at the same time of day over a week.
- 💡If you smoke, quitting is the single most impactful change you can make. Risk begins dropping within days and is halved within a year. Use every resource available - medication, counseling, apps.
- 💡Print your risk score results and bring them to your next doctor appointment. Having a concrete number facilitates a more productive conversation about prevention.
- 💡Consider a coronary artery calcium (CAC) scan if your 10-year risk is 7.5-19.9% (intermediate) - a zero score may allow you to defer statin therapy with confidence.
- 💡Focus on the modifiable factors: cholesterol, blood pressure, blood sugar, weight, and smoking status. Age and genetics are fixed, but they're actually the minority of your total risk.
- 💡Try the Portfolio Diet: daily nuts, plant sterols, soluble fiber (oats, beans), and soy protein. Research shows it may reduce heart disease mortality by 18% - comparable to some medications.
- 💡Aim for 150 minutes of moderate exercise weekly, but even 15 minutes of daily walking provides meaningful protection. Something is far better than nothing.
- 💡Know your family history. If a parent or sibling had heart disease before age 55 (men) or 65 (women), tell your doctor - this is a major risk enhancer not captured in most calculators.
- 💡Women with a history of preeclampsia, gestational diabetes, or early menopause should discuss cardiovascular screening with their doctor - these conditions increase lifetime risk.
- 💡Manage stress proactively. Chronic stress increases heart disease risk by 40%, and angry outbursts can increase heart attack risk 5-fold in the two hours following. Meditation, exercise, and social connection all help.
- 💡Download your risk results and recalculate annually (if intermediate/high risk) or after major lifestyle changes. Track your progress - seeing your risk drop is powerful motivation.
Frequently Asked Questions
Age is the dominant factor - risk approximately doubles each decade after 55. Even with optimal cholesterol and blood pressure, a 70-year-old has higher risk than a 40-year-old with multiple risk factors. This is why primary prevention focuses on addressing modifiable factors early in life. If your risk seems high despite good numbers, remember that the calculator weighs age heavily because cumulative exposure to even minor risk factors compounds over time.
