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Framingham Risk Score Calculator
Calculate 10-year cardiovascular disease risk using the Framingham Risk Score. Evaluates age, sex, cholesterol, blood pressure, smoking, and diabetes.
⚠️ Medical Disclaimer: This is a screening tool. Treatment decisions should incorporate the full ASCVD risk calculator, coronary calcium score, and clinical assessment. Consult your provider before starting medications.
years
mg/dL
mg/dL
mmHg
10-Year CVD Risk14.0%
▼
Low (<5%)BorderlineIntermediateHigh (≥20%)
10-Year Cardiovascular Risk
14.0%
Intermediate Risk
Formal prevention discussion may be appropriate
10-Year CVD Risk⧉
14.0%
Intermediate Risk
Risk Category⧉
Intermediate Risk
Formal prevention discussion may be appropriate
Optimal Risk⧉
7.3%
With optimal risk factors at age 55
Heart Age⧉
~68 yrs
Chronological age: 55
TC/HDL Ratio⧉
4.4
Acceptable
Prevention Follow-Up⧉
Clinician review advised
Compare with ASCVD-focused guidance and risk enhancers
| Risk Category | 10-Year Risk | Typical Next Step |
|---|---|---|
| Low | <5% | Focus on lifestyle and routine follow-up |
| Borderline | 5-9.9% | Review risk enhancers and consider formal ASCVD assessment |
| Intermediate | 10-19.9% | Clinician-led prevention discussion; compare with current guideline tools |
| High | ≥20% | Comprehensive prevention review rather than score-only decisions |
| Risk Factor | Current Value | Optimal Target |
|---|---|---|
| Total Cholesterol | 220 mg/dL | <200 mg/dL |
| HDL Cholesterol | 50 mg/dL | >60 mg/dL |
| Blood Pressure | 140 mmHg | <120 mmHg |
| Smoking | No | Non-smoker |
| Diabetes | No | No |
Planning notes, formulas, and examples
About the Framingham Risk Score Calculator
The Framingham Risk Score (FRS) estimates 10-year cardiovascular disease risk using data from the Framingham Heart Study, which began in Framingham, Massachusetts in 1948. The calculator uses age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, antihypertensive treatment, smoking status, and diabetes to produce a risk estimate.
The result is usually interpreted in broad categories: low risk favors lifestyle focus, borderline and intermediate risk may justify a statin discussion if other risk enhancers are present, and higher risk generally supports more intensive prevention.
Although the ASCVD pooled cohort equations are preferred in many contemporary guidelines, Framingham remains a familiar screening model and is still useful for initial cardiovascular risk discussions. This calculator also shows heart age, optimal-risk comparison, and the TC/HDL ratio.
When This Page Helps
Risk scores help turn a long list of cardiovascular risk factors into a single estimate that is easier to discuss with a patient or compare over time. The heart-age view is often easier to interpret than a percentage alone because it puts the estimate into a more intuitive frame.
This page is best used as a risk-discussion aid rather than a medication rule. Contemporary prevention guidance typically relies on ASCVD-focused models for statin decisions, with Framingham serving as a familiar general-risk reference.
How to Use the Inputs
- Select biological sex.
- Enter age (valid range 30-79 years).
- Enter the latest available total cholesterol and HDL cholesterol values.
- Enter systolic blood pressure.
- Indicate if you take blood pressure medication.
- Indicate smoking status and diabetes diagnosis.
- Review the 10-year risk, category, heart age, and comparison to optimal.
Formula used
Framingham Risk Score uses sex-specific Cox proportional hazards models:
Male: S₁₀ = 1 − 0.88936^exp(ΣβᵢXᵢ − 23.9802)
Female: S₁₀ = 1 − 0.95012^exp(ΣβᵢXᵢ − 26.1931)
where βᵢ are regression coefficients for each risk factor and Xᵢ are log-transformed values.Example Calculation
Result: 12.5% — Intermediate Risk
A 55-year-old non-smoking, non-diabetic male with total cholesterol 220, HDL 50, and SBP 140 has an intermediate 10-year CVD risk. This risk would benefit from statin discussion especially if risk enhancers (family history, metabolic syndrome, elevated CRP) are present.
Tips & Best Practices
- Use fasting lipid panel values if you want the score to match the standard worksheet inputs as closely as possible.
- If blood pressure varies, use the average of several recent readings.
- Risk scores are validated for ages 30-79 — extrapolation beyond this range is less reliable.
- A coronary artery calcium (CAC) score of 0 in borderline/intermediate risk patients can reclassify risk downward.
- Smoking cessation is the single most impactful modifiable risk factor for CVD reduction.
- Family history of premature CVD (male <55, female <65) is a risk enhancer not captured in the score.
Statin Decision Framework
Current AHA/ACC cholesterol guidance organizes statin decisions into four familiar benefit groups: (1) Clinical ASCVD — high-intensity statin, (2) LDL ≥190 — high-intensity statin without risk calculation, (3) Diabetes age 40-75 — moderate-intensity statin, (4) 10-year risk ≥7.5% age 40-75 — discuss statin with risk enhancer assessment and optional CAC scoring.
Risk Enhancers
Factors that favor statin therapy in the borderline/intermediate risk range: family history of premature ASCVD, persistently elevated LDL ≥160 mg/dL, metabolic syndrome, chronic kidney disease, chronic inflammatory conditions (RA, psoriasis, HIV), history of preeclampsia or premature menopause, South Asian ancestry, elevated hsCRP (≥2 mg/L), elevated Lp(a) (≥50 mg/dL or ≥125 nmol/L), elevated ApoB (≥130 mg/dL), or ankle-brachial index <0.9.
Coronary Artery Calcium Scoring
CAC scoring is the most powerful risk reclassifier available. CAC=0 is associated with very low event rates (<1% per decade) and can defer statin therapy in borderline/intermediate risk patients. CAC ≥100 or ≥75th percentile favors statin initiation. CAC is not recommended for low-risk (<5%) or high-risk (≥20%/known ASCVD) patients.
Sources & Methodology
Last updated:
Methodology
This calculator applies the sex-specific Framingham general cardiovascular disease equations published for adults without baseline CVD, using age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment status, smoking, and diabetes. The core 10-year risk output is the main validated result on the page.
The heart-age and treatment-discussion layers are secondary interpretation aids rather than substitute guideline decisions. Current lipid-management decisions usually rely on newer ASCVD-focused prevention workflows, so this page should be used to frame risk discussion, not as a stand-alone statin rule.
Sources
- General cardiovascular risk profile for use in primary care: the Framingham Heart Study (PubMed / Circulation)
- Cardiovascular Disease (10-year risk) (Framingham Heart Study)
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease (PubMed / Circulation) — Useful for current prevention context and why Framingham is not the only treatment-decision framework in use.
Frequently Asked Questions
The Pooled Cohort Equations use data from multiple cohorts, include race as a variable, and focus on atherosclerotic cardiovascular disease. Framingham is older, broader in scope, and still useful as a familiar screening model.
No. Framingham risk is a general-risk estimate, not a stand-alone statin rule. Contemporary prevention guidance typically uses ASCVD-focused tools, risk enhancers, and sometimes coronary artery calcium scoring to guide medication decisions.
The FRS tends to overestimate risk in low-risk populations (East Asian, Mediterranean). It may underestimate risk in South Asian, African American, and familial hypercholesterolemia populations. The ASCVD calculator partially addresses racial differences for Black and White Americans.
Heart age compares your actual risk to the risk that would be expected if all modifiable risk factors were at optimal levels. A 55-year-old with a heart age of 70 has the CVD risk of an average 70-year-old. This concept motivates lifestyle change more effectively than abstract probability.
Every 4-6 years for low-risk individuals, or whenever risk factors change significantly. After starting statin therapy, the calculator loses some validity because statins reduce both cholesterol levels and risk beyond what the lipid change alone would predict.
Total cholesterol and HDL are used because the TC/HDL ratio captures atherogenic risk better than any single lipid measure. LDL can be calculated from these values (Friedewald equation) and is used for treatment targets and monitoring, but TC and HDL proved more predictive in the original Framingham models.
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