ASCVD risk score chart: what your 10-year score means
By HeartRiskCalc Editorial Team · Published · Updated
Based on the 2013 and 2018 ACC/AHA guidelines and the 2026 dyslipidemia guideline. Not independently reviewed by a clinician.
In short: an ASCVD risk score under 5% is low, 5% to 7.4% is borderline, 7.5% to 19.9% is intermediate, and 20% or higher is high. Under the 2018 ACC/AHA guideline, 7.5% was the main threshold for discussing a statin with your clinician. Lower is always better, but age is the strongest input.
Your ASCVD risk score is the estimated percent chance of a first heart attack, death from coronary heart disease, or stroke in the next 10 years. A score of 6% means that among 100 people with the same numbers, about 6 would be expected to have one of those events within 10 years. It comes from the 2013 ACC/AHA Pooled Cohort Equations and applies to adults 40 to 79 who have never had one of those events.
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ASCVD risk score ranges chart
The 2018 ACC/AHA cholesterol guideline groups the 10-year score into four categories:
| 10-year ASCVD score | Category | Out of 100 people like you |
|---|---|---|
| Under 5% | Low | Fewer than 5 would have a heart attack or stroke in 10 years |
| 5% to 7.4% | Borderline | About 5 to 7 |
| 7.5% to 19.9% | Intermediate | About 8 to 20 |
| 20% or higher | High | 20 or more |
Low
Under 5%Lifestyle is the main focus. A low 10-year score does not mean low lifetime risk, especially if you are under 50.
Borderline
5% to 7.4%Risk enhancers such as family history, LDL of 160 or higher, or chronic inflammatory disease can tip the conversation toward a statin.
Intermediate
7.5% to 19.9%Under the 2018 guideline this was the range where a moderate-intensity statin was recommended after a clinician–patient discussion.
High
20% or higherClinicians typically recommend treating cholesterol more intensively, aiming for a larger LDL reduction.
These categories start a conversation; they do not decide treatment on their own. Clinicians also weigh LDL cholesterol, family history, and conditions the equation leaves out, and may use a coronary artery calcium scan when the decision is unclear.
ASCVD risk score chart by age
Age drives the score more than any other factor. The chart below shows example 10-year scores for three illustrative profiles, calculated with the same equation our calculator uses. They are examples, not population averages.
- Optimal: total cholesterol 170, HDL 50, systolic BP 110, no diabetes, non-smoker.
- Typical: total cholesterol 200, HDL 50, systolic BP 130, no diabetes, non-smoker.
- Higher risk: same as typical, plus smoking and treated systolic BP of 150.
| Age | Men | Women | ||||
|---|---|---|---|---|---|---|
| Optimal | Typical | Higher risk | Optimal | Typical | Higher risk | |
| 45 | 1.2% | 2.1% | 8.4% | 0.5% | 1.0% | 5.9% |
| 55 | 3.6% | 5.7% | 15.7% | 1.4% | 2.2% | 9.6% |
| 65 | 8.8% | 13.1% | 25.9% | 4.0% | 6.0% | 18.7% |
| 75 | 18.6% | 25.3% | 38.4% | 12.0% | 16.5% | 38.0% |
A 65-year-old man with typical numbers already lands in the intermediate range, while a 45-year-old with the same numbers is low. That is why younger adults with risk factors are encouraged to look at lifetime or 30-year risk as well — or try our heart age calculator to see how many years their risk factors add.
The ASCVD score and statins
For most of the last decade, 7.5% was the number that mattered: the 2018 guideline recommended discussing a moderate-intensity statin for adults 40–75 with a 10-year score of 7.5% to 19.9%, and considering one at 5% to 7.4% when risk enhancers were present. Some people are treated regardless of the score — LDL of 190 mg/dL or higher, or diabetes between ages 40 and 75.
In 2026 the ACC/AHA dyslipidemia guideline replaced this score with the PREVENT-ASCVD equations for treatment decisions. PREVENT uses lower cut-offs (borderline from 3%, intermediate from 5%) because it gives lower estimates for the same person. A 6% ASCVD score and a 6% PREVENT score are not the same result.
ASCVD score vs. PREVENT
PREVENT was built from more recent data on over 6 million U.S. adults. It removes race, adds kidney function, BMI, and statin use, starts at age 30, and adds heart failure and 30-year estimates. The older equation tends to overestimate risk in today's population, so PREVENT results are usually lower.
If your clinician quoted an ASCVD score from a past visit, it still shows which factors carry the most weight for you. For the model current guidelines use, try our PREVENT calculator. For the full math behind the older score, see the methodology page.
ASCVD risk score: FAQ
What is a good 10-year ASCVD risk score?
Under 5% is considered low risk under the 2018 ACC/AHA cholesterol guideline, and lower is always better. But "good" depends on age: because age is the strongest input, a healthy 70-year-old can score above 10% while a 45-year-old with several risk factors still scores under 5%. That is why a low 10-year score in your 40s does not rule out a high lifetime risk.
What ASCVD risk score means you should start a statin?
The 2018 ACC/AHA guideline used 7.5% as the main threshold: at 7.5% to 19.9% a moderate-intensity statin was recommended after a discussion with your clinician, and at 5% to 7.4% it could be considered when risk enhancers were present. In 2026 the updated ACC/AHA dyslipidemia guideline moved to the PREVENT-ASCVD equations, with lower cut-offs (3% borderline, 5% intermediate). The two scores are not interchangeable, so ask which one your clinician is using. LDL of 190 mg/dL or higher and diabetes in adults 40–75 are treated regardless of the score.
Is a 7.5% ASCVD risk score high?
It is intermediate, not high. A 7.5% score means that out of 100 people with the same numbers, about 7 or 8 would be expected to have a heart attack or stroke in the next 10 years. It was the point where the 2018 guideline recommended discussing a statin. High risk starts at 20%.
What is the difference between CVD and ASCVD?
CVD (cardiovascular disease) covers every disease of the heart and blood vessels, including heart failure, arrhythmias, and valve disease. ASCVD (atherosclerotic cardiovascular disease) is the subset caused by plaque buildup in the arteries: heart attack, coronary heart disease death, stroke, and peripheral artery disease. The ASCVD risk score predicts only the atherosclerotic events; PREVENT also estimates heart failure and total CVD.
How is the ASCVD risk score calculated?
The 2013 Pooled Cohort Equations combine sex, age, race, total and HDL cholesterol, systolic blood pressure, blood pressure treatment, diabetes, and smoking. Each value is log-transformed, multiplied by a published coefficient, and converted into a 10-year probability. There are four coefficient sets for White and African American men and women. Our methodology page shows the full equation.
Can my ASCVD risk score go down?
Yes, for the factors you can change. Quitting smoking, lowering blood pressure, and improving cholesterol all reduce the calculated score. Age always pushes it up over time, so a score that stays flat as you get older usually reflects real improvement. Note that the equation was not designed to measure how much treatment has lowered your risk; your clinician may interpret a score calculated on medication differently.
Sources and editorial notes
- Goff DC Jr, et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Circulation. 2014;129(25 Suppl 2):S49–S73.
- Grundy SM, et al. 2018 AHA/ACC Guideline on the Management of Blood Cholesterol. Circulation. 2019;139(25):e1082–e1143.
- ACC/AHA — 2026 Guideline on the Management of Dyslipidemia (summary)
Sources checked September 25, 2026. Educational information only; this article does not replace advice from your healthcare professional.