Framingham Risk Score Calculator — 10-Year Cardiovascular Disease (CVD) Risk
Calculate the 10-year risk of developing cardiovascular disease (myocardial infarction or coronary death) to guide statin and antihypertensive primary prevention.
Framingham Risk Score Calculator
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This calculator is for informational and educational purposes. Results should be interpreted with clinical judgment and local guidelines.
What is the Framingham Risk Score?
The Framingham Risk Score is a validated gender-specific algorithm derived from the landmark Framingham Heart Study to estimate a person's 10-year probability of developing coronary heart disease (CHD) or hard cardiovascular events (myocardial infarction or coronary death). First published by Wilson et al. in 1998 and updated by D'Agostino et al. in 2008 for general CVD, the model integrates Age, Total Cholesterol, HDL Cholesterol, Systolic Blood Pressure (and hypertension treatment status), Smoking status, and Diabetes status. It is recommended by ACC/AHA guidelines for cardiovascular primary prevention screening in adults aged 30 to 79 without established ASCVD.
Framingham Score calculates 10-year CVD risk percentage. Low Risk: < 10% (lifestyle modification). Intermediate Risk: 10–20% (consider moderate-intensity statin). High Risk: > 20% (statin + BP target < 130/80 mmHg).
When to Use the Framingham Risk Score
- Primary prevention screening in adults aged 30–79 without known coronary artery disease, stroke, or peripheral artery disease.
- Initiating statin therapy: Guiding ACC/AHA decisions on primary prevention lipid-lowering therapy.
- Setting blood pressure targets and anti-hypertensive initiation decisions.
Framingham Multi-Factorial Model Variables
General Framingham CVD Risk Model
Risk (%) = 1 − S₀(t)^exp(β₁×ln(Age) + β₂×ln(TotChol) + β₃×ln(HDL) + β₄×ln(SBP) + β₅×Smoker + β₆×Diabetes − Meanβ)
Male 55, TotChol 220, HDL 45, SBP 138 (treated), Smoker → 10-Year CVD Risk ≈ 16.4% (Intermediate Risk).
Variables
Age (years)
Patient age (validated for 30–79 years).
Total Cholesterol (mg/dL)
Fasted or non-fasted total serum cholesterol.
HDL Cholesterol (mg/dL)
High-density lipoprotein cholesterol. Higher HDL reduces risk.
Systolic BP & Treatment (mmHg & status)
Systolic blood pressure and whether patient is taking antihypertensive medication.
Smoking Status (boolean)
Current cigarette smoking status.
Diabetes Status (boolean)
Diagnosed diabetes mellitus.
For patients with established ASCVD, prior MI, or severe familial hypercholesterolemia (LDL ≥ 190 mg/dL), 10-year risk assessment is unnecessary as high-intensity statin therapy is automatically indicated.
10-Year CVD Risk Stratification & Statin Guidance
ACC/AHA 2019 Primary Prevention Guidelines risk categories.
| Range | Classification | Health Risk |
|---|---|---|
| < 5% Risk | Low Risk | Emphasize lifestyle (diet, exercise, smoking cessation). |
| 5%–7.4% Risk | Borderline Risk | Risk discussion; consider moderate-intensity statin if risk enhancers present. |
| 7.5%–19.9% Risk | Intermediate Risk | Moderate-intensity statin recommended (e.g. Atorvastatin 20mg). |
| ≥ 20% Risk | High Risk | High-intensity statin recommended (Atorvastatin 40–80mg / Rosuvastatin 20–40mg). BP target < 130/80. |
Risk enhancers (family history of premature ASCVD, chronic kidney disease, metabolic syndrome, inflammatory diseases) can reclassify borderline/intermediate risk patients to higher treatment tiers.
Limitations & Clinical Warnings
Framingham may underestimate risk in South Asian populations and socioeconomically disadvantaged groups.
May overestimate risk in low-incidence modern populations; PCE (Pooled Cohort Equations) and PREVENT 2023 equations are also used.
Medical Disclaimer
Use Framingham score as part of a clinician-patient risk discussion before initiating lifelong statin therapy.
References & Citations
- D'Agostino RB, Vasan RS, Pencina MJ, et al.. “General cardiovascular risk profile for use in primary care: the Framingham Heart Study”. Circulation. 2008. 117(6): 743–753. PMID: 18212285 | DOI: 10.1161/CIRCULATIONAHA.107.699579
- Arnett DK, Blumenthal RS, Albert MA, et al.. “2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease”. Circulation. 2019. 140(11): e596–e646. PMID: 30875255
Medically Reviewed
Reviewed by CliniqWise Clinical Advisory Board — Preventive Cardiology Panel · Last updated: 2026-08-27 · Next review: 2027-02-27
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