Framingham Risk Score
Estimates 10-year cardiovascular disease (CVD) risk using the Framingham Heart Study algorithm. Calculates risk based on age, sex, cholesterol levels, blood pressure, smoking status, and diabetes.
Patient Information
Optimal Risk Factor Targets
10-Year CVD Risk
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About This Calculator
The Framingham Risk Score is a sex-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. Originally derived from the Framingham Heart Study, it has been one of the most widely used cardiovascular risk prediction tools since its development.
The score uses traditional cardiovascular risk factors including age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, smoking status, and diabetes to calculate the probability of developing cardiovascular disease within the next 10 years.
This calculator uses the 2008 Framingham General Cardiovascular Risk Score which predicts overall cardiovascular disease (CVD) risk, including coronary heart disease, stroke, peripheral artery disease, and heart failure.
Formula
Risk = 1 - S₀^exp(ΣβᵢXᵢ - ΣβᵢX̄ᵢ), where S₀ is the baseline survival at 10 years and β are regression coefficients for each risk factorThe Framingham Risk Score uses Cox proportional hazards regression coefficients derived from the Framingham Heart Study cohort. Different coefficients are used for men and women. The score incorporates: • Age (log-transformed) • Total cholesterol (log-transformed) • HDL cholesterol (log-transformed) • Systolic blood pressure (log-transformed, with different weights for treated vs untreated) • Smoking status (binary) • Diabetes status (binary)
Clinical Considerations
- •This calculator is validated for adults aged 30-79 years without known cardiovascular disease
- •Not intended for patients with prior CVD events (secondary prevention)
- •Results should be interpreted in clinical context with other risk factors
- •Consider using ASCVD Risk Estimator for more current guideline-based recommendations
- •Does not account for family history, obesity, or inflammatory markers
Limitations
- •Based on predominantly white population from Framingham, MA
- •May underestimate risk in certain ethnic groups
- •Does not include newer risk factors (CRP, coronary calcium, etc.)
- •Static risk estimate that does not account for risk factor changes over time
Interpretation Guide
| Range | Classification | Recommendation |
|---|---|---|
| <-10 | Low Risk | Low 10-year CVD risk. Focus on lifestyle optimization including diet, exercise, and smoking cessation if applicable. |
| 10-20 | Intermediate Risk | Intermediate 10-year CVD risk. Consider additional risk assessment. Lifestyle modifications strongly recommended. Discuss statin therapy per guidelines. |
| 20-100 | High Risk | High 10-year CVD risk (≥20%). Intensive lifestyle intervention recommended. Statin therapy typically indicated per ACC/AHA guidelines. |
Frequently Asked Questions
What is the Framingham Risk Score?
The Framingham Risk Score is a validated algorithm that estimates the 10-year probability of developing cardiovascular disease based on traditional risk factors including age, sex, blood pressure, cholesterol levels, smoking status, and diabetes.
Who should use this calculator?
This calculator is intended for primary prevention in adults aged 30-79 without known cardiovascular disease. It helps clinicians and patients understand cardiovascular risk and guide decisions about lifestyle modifications and preventive therapies.
How accurate is the Framingham Risk Score?
The Framingham Risk Score has been validated in multiple populations and generally provides reasonable risk estimates. However, it may under- or overestimate risk in certain populations, particularly non-white ethnic groups. Modern calculators like the ASCVD Risk Estimator may provide more tailored estimates.
What should I do if my risk is high?
A high Framingham Risk Score (≥20% 10-year risk) indicates that intensive cardiovascular risk reduction is appropriate. This typically includes lifestyle modifications (diet, exercise, smoking cessation) and consideration of statin therapy. Discuss your results with your healthcare provider.
References
1. D'Agostino RB Sr, Vasan RS, Pencina MJ, et al.. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008. doi: 10.1161/CIRCULATIONAHA.107.699579
View Source →2. Wilson PW, D'Agostino RB, Levy D, et al.. Prediction of coronary heart disease using risk factor categories. Circulation. 1998. doi: 10.1161/01.cir.97.18.1837
View Source →Last updated: 2025-01-15
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