ASCVD Score: What It Is and How It Predicts Heart Disease Risk

When doctors talk about your risk for a heart attack or stroke, they’re often looking at something called the ASCVD score, a calculated estimate of your 10-year risk of atherosclerotic cardiovascular disease, including heart attack and stroke. Also known as atherosclerotic cardiovascular disease risk score, it’s one of the most widely used tools in preventive cardiology to decide if you need statins or other interventions before something serious happens.

The ASCVD score pulls together simple data—your age, sex, race, cholesterol levels, blood pressure, whether you smoke, and if you have diabetes—and turns it into a percentage. That number isn’t just a guess. It’s based on data from over 130,000 people tracked for decades by the American Heart Association and the American College of Cardiology. If your score is 7.5% or higher, guidelines say you should consider starting a statin, even if your cholesterol isn’t wildly high. Many people are surprised by their score because they feel fine. But that’s the point: it catches risk before symptoms show up.

This score doesn’t work for everyone. It’s designed for adults between 40 and 79 who don’t already have heart disease, diabetes, or very high LDL cholesterol. If you’re younger than 40, your risk might be rising fast but won’t show up here yet. If you’re over 80, the math doesn’t apply. And if you have familial hypercholesterolemia or kidney disease, your doctor will use other tools. Still, for most people, the ASCVD score is the starting point for real prevention. It’s why some people with normal cholesterol get statins, while others with high cholesterol don’t. It’s not about single numbers—it’s about the full picture.

What you’ll find in the posts below are real-world connections to how this score plays out in practice. You’ll see how cholesterol levels and blood pressure directly feed into the calculation, how statins are chosen based on the result, and why some people with a low score still end up with heart problems. You’ll also find posts on drug interactions, like how ACE inhibitors and potassium-sparing diuretics can complicate treatment, or how atorvastatin might be used beyond just lowering cholesterol. There’s no fluff here—just clear links between your score and the medications, tests, and lifestyle changes that follow.