Frequently Asked Questions

The ASCVD risk score is based on the Pooled Cohort Equations algorithm developed from ACC/AHA 2013 guidelines. It estimates your probability of having a cardiovascular event (such as heart attack or stroke) within the next 10 years. The score is based on factors including age, sex, race, cholesterol levels, blood pressure, diabetes, and smoking status.

Our calculator uses the same algorithm as clinical guidelines, but is for reference only. It was developed from large population studies, but individual circumstances may vary. We recommend discussing your results with your doctor for personalized advice.

We recommend calculating once a year, or whenever there are significant changes in your health (such as cholesterol level changes, starting or stopping medications, quitting smoking, etc.).

Low risk (<5%): Less than 5% chance of a cardiovascular event in 10 years. Borderline risk (5-7.4%): Consider lifestyle changes. Intermediate risk (7.5-19.9%): Lifestyle changes and possibly medication. High risk (≥20%): Aggressive risk factor management and medication usually recommended.

The Pooled Cohort Equations are validated for adults aged 40-79 without existing cardiovascular disease. They may be less accurate for very young or very old individuals, those with extremely high or low risk factors, or people with conditions like familial hypercholesterolemia.

The calculator includes race because studies have shown that African Americans have a higher risk of cardiovascular disease at the same cholesterol and blood pressure levels compared to other groups. This reflects real health disparities and helps ensure appropriate risk assessment.

If you already have cardiovascular disease (prior heart attack, stroke, or diagnosed coronary artery disease), you're considered "secondary prevention" and don't need this calculator—you're already in a high-risk category that requires ongoing management.

LDL (Low-Density Lipoprotein) is called "bad cholesterol" because it builds up in artery walls forming plaque. HDL (High-Density Lipoprotein) is called "good cholesterol" because it helps remove LDL from your blood. Ideally, you want low LDL and high HDL levels.

Ways to lower cholesterol include: reducing saturated and trans fat intake, increasing dietary fiber, regular exercise, quitting smoking, and limiting alcohol consumption. If lifestyle changes aren't enough, your doctor may recommend medication.

Generally, total cholesterol below 200 mg/dL is considered ideal. 200-239 mg/dL is borderline high, and 240 mg/dL or above is high. However, it's more important to look at the specific values of LDL, HDL, and triglycerides.

Adults 20 and older should have cholesterol tested every 5 years. More frequent testing is recommended if you have cardiovascular risk factors, abnormal results, or are taking cholesterol-lowering medications.

Traditionally, fasting for 9-12 hours was required. However, many doctors now accept non-fasting lipid panels for screening. Fasting is still recommended when measuring triglycerides or for precise LDL calculation. Check with your doctor.

Yes. The American Academy of Pediatrics recommends cholesterol screening for all children between ages 9-11 and again at 17-21. Earlier testing is recommended for children with family history of high cholesterol or early heart disease.

Statins are medications that block a substance your liver needs to make cholesterol. They're the most effective drugs for lowering LDL cholesterol, typically reducing it by 30-50% or more. They also have anti-inflammatory effects that benefit blood vessels.

Foods that help lower cholesterol include: oats and whole grains, fatty fish (salmon, mackerel), nuts (especially almonds and walnuts), beans and legumes, fruits (especially those with soluble fiber like apples and citrus), vegetables, and olive oil.

Eggs contain dietary cholesterol, but for most people, dietary cholesterol has less impact on blood cholesterol than saturated and trans fats. For healthy adults, 1 egg per day is generally fine. If you have high cholesterol or diabetes, limit to 3-4 eggs per week.

Coconut oil raises both LDL (bad) and HDL (good) cholesterol. While some claim it's healthy, major health organizations recommend limiting coconut oil due to its high saturated fat content. Use olive oil or other unsaturated fats instead.

Normal blood pressure should be below 120/80 mmHg. Systolic (top number) 120-129 with diastolic (bottom number) below 80 is "elevated blood pressure." 130/80 or higher is defined as hypertension according to ACC/AHA guidelines.

Sit quietly for 5 minutes before measuring, avoid caffeine and smoking for 30 minutes prior, don't cross your legs, and keep your arm at heart level. We recommend measuring at the same time each day and recording multiple readings to get an average.

Blood pressure naturally rises in the early morning hours due to your body's circadian rhythm. This "morning surge" is normal but can be pronounced in people with hypertension. It's also why morning is a peak time for heart attacks and strokes.

Yes, blood pressure naturally fluctuates. It's typically lowest during sleep and rises during the day. Physical activity, stress, caffeine, and meals can cause temporary increases. This is why multiple readings over time are important.

White coat hypertension is when your blood pressure is elevated in medical settings but normal at home. It affects about 15-30% of people with elevated office readings. Home monitoring or 24-hour ambulatory monitoring can help diagnose it.

Systolic pressure (top number) measures the pressure in your arteries when your heart beats and pumps blood. Diastolic pressure (bottom number) measures the pressure when your heart rests between beats. Both are important, but systolic becomes more predictive of risk with age.

The American Heart Association recommends less than 2,300 mg/day, ideally no more than 1,500 mg/day for those with high blood pressure. Most Americans consume 3,400+ mg/day. Most sodium comes from processed and restaurant foods, not the salt shaker.

DASH (Dietary Approaches to Stop Hypertension) is a diet plan proven to lower blood pressure. It emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting sodium, saturated fats, and sweets. Studies show it can lower blood pressure by 8-14 mmHg.

Blood pressure: At least every 2 years if normal, more often if elevated. Cholesterol: Every 5 years starting at age 20, more often with risk factors. Blood glucose: Every 3 years starting at age 45, or earlier with risk factors. Discuss with your doctor for personalized recommendations.

A complete lipid panel includes: Total cholesterol, LDL cholesterol (calculated or direct), HDL cholesterol, Triglycerides, and sometimes non-HDL cholesterol and total cholesterol to HDL ratio. Some advanced tests also measure particle size and number.

A coronary calcium scan is a CT scan that measures calcium deposits in your coronary arteries. A higher score indicates more plaque and higher risk. It can help guide treatment decisions for people at intermediate risk.

Depending on your risk factors, your doctor may order: EKG/ECG (electrical activity), echocardiogram (heart ultrasound), stress test (exercise or chemical), coronary calcium scan, or advanced lipid testing. Blood tests may include CRP (inflammation marker) and HbA1c (diabetes marker).

Quality home blood pressure monitors can be very accurate when used correctly. Look for devices validated by the American Heart Association or British Hypertension Society. Upper arm cuffs are generally more accurate than wrist monitors. Bring your device to your doctor to check accuracy.

An ambulatory blood pressure monitor is a device worn for 24 hours that automatically measures your blood pressure at regular intervals during daily activities and sleep. It provides a comprehensive picture of your blood pressure patterns and is considered the gold standard for diagnosis.

Foods high in saturated fats (red meat, full-fat dairy, butter) and trans fats (some processed foods, fried foods, baked goods) are worst for cholesterol. Organ meats and shellfish are high in dietary cholesterol but may not affect blood cholesterol as much as saturated fats.

No. Unsaturated fats (monounsaturated and polyunsaturated) are actually heart-healthy. They're found in olive oil, avocados, nuts, seeds, and fatty fish. Focus on replacing saturated and trans fats with these healthier options.

Adults should aim for 25-35 grams of fiber per day. Soluble fiber (oats, beans, apples, citrus) is especially beneficial for lowering cholesterol. Most Americans get only 15 grams daily—increasing fiber intake can significantly improve heart health.

Some studies suggest moderate red wine consumption may have cardiovascular benefits, possibly due to antioxidants like resveratrol. However, the American Heart Association does not recommend alcohol for health benefits. If you don't drink, don't start. If you drink, limit to 1 drink/day (women) or 2 drinks/day (men).

Evidence supports several dietary patterns: Mediterranean diet, DASH diet, and plant-based diets. Common elements include: lots of vegetables, fruits, whole grains, legumes, nuts; lean proteins (fish, poultry) or plant proteins; limited red meat, processed foods, and sugary beverages.

Most heart health supplements lack strong evidence. Omega-3 fatty acids may help if you don't eat fish. Plant sterols/stanols can lower LDL. For most people, getting nutrients from food is better than supplements. Talk to your doctor before starting any supplement.

Aerobic exercise (cardio) like walking, jogging, swimming, or cycling is most beneficial. However, combining cardio with strength training provides the best overall benefits. Aim for at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week, plus strength training twice weekly.

Yes, in fact, exercise is recommended! Regular physical activity can lower blood pressure by 5-8 mmHg. Start slowly with moderate-intensity activities like walking. If your blood pressure is very high (above 180/110), consult your doctor before starting vigorous exercise.

Blood pressure improvements can be seen within a few weeks of regular exercise. Cholesterol improvements typically take 3-6 months. Cardiovascular fitness improvements begin within 2-4 weeks. Consistency is more important than intensity—regular moderate exercise beats sporadic intense workouts.

If you have diagnosed heart disease, exercise is usually beneficial but should be done under medical guidance. Cardiac rehabilitation programs provide supervised exercise. Always get clearance from your doctor before starting a new exercise program.

Absolutely! Brisk walking is one of the best forms of exercise for heart health. It's accessible, low-impact, and effective. Aim for 30 minutes of brisk walking (3-4 mph) most days of the week. You can break it into three 10-minute walks if needed.

For most people with hypertension, medication is long-term. However, lifestyle changes (weight loss, exercise, diet) may allow some people to reduce or even stop medication under medical supervision. Never stop medication without consulting your doctor.

Most people tolerate statins well. Common side effects include mild muscle aches. Rare but serious side effects include severe muscle damage (rhabdomyolysis) and liver enzyme elevation. Memory issues have been reported but studies show no significant cognitive harm. Discuss any concerns with your doctor.

Some medications work better at certain times. Blood pressure medications are often taken at bedtime because they're more effective and reduce nighttime and morning blood pressure surges. Some statins are better absorbed in the evening. Follow your doctor's specific instructions.

Alcohol can interact with many heart medications and may increase side effects. It can also raise blood pressure and interfere with the effectiveness of certain drugs. Talk to your doctor about safe alcohol consumption with your specific medications.

If you miss a dose, take it as soon as you remember unless it's almost time for your next dose. In that case, skip the missed dose—never double up. Setting reminders or using a pill organizer can help prevent missed doses. Talk to your doctor if you frequently miss doses.

The free version offers 3 risk calculations, history storage (up to 20 entries), and trend charts. Pro ($2/month) offers unlimited calculations and CSV export. ProMAX ($5/month) additionally offers PDF report export and What-If simulator.

You can cancel anytime from your profile page. After cancellation, you can still use paid features until the current billing period ends. We don't charge cancellation fees.

Your health data is stored in your browser's local storage and synced through your Google account (if you're logged in). We don't sell or share your personal health information with third parties.

We currently support PayPal for secure payments. We plan to support more payment methods in the future.

The What-If simulator is a ProMAX feature that helps you predict how lifestyle changes might affect your risk. For example, it calculates how your risk would change if you quit smoking, lower your cholesterol, or reduce your blood pressure.

The PDF report includes your risk score, input health data, risk level explanation, and general recommendations. It's perfect for sharing with your doctor for discussion.

Calculation history is stored in your browser's local storage. If you log in with your Google account, data syncs to the cloud and can be accessed across different devices.

Yes! Pro and ProMAX users can export their calculation history as CSV files, which can be opened in Excel or Google Sheets for further analysis.