Preoperative cardiac risk stratification algorithms typically use a Bayesian approach to identify a low-risk category group for which the outcome is unlikely to be improved by further testing. This report suggests evaluating common carotid intima-media thickness (CCIMT) as measured by ultrasound to determine whether it strengthens and optimizes perioperative Bayesian risk indices. The idea proposes to use CCIMT Z score and vascular age to quantify atherosclerotic burden. CCIMT may be useful as part of shared decision-making for perioperative care. A website (www.suhitam.com/vascularage) designed by one of the authors (S.M.) is a useful resource.).