Calculate 10-year cardiovascular disease risk using the Framingham Risk Score. Evaluates age, sex, cholesterol, blood pressure, smoking, and diabetes.
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 now preferred in many current 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.
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. Current prevention guidelines typically rely on ASCVD-focused models for statin decisions, with Framingham serving as a familiar general-risk reference.
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.
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.
The 2018 AHA/ACC Cholesterol Guidelines establish four statin 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.
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.
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.
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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.
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. Current prevention guidelines typically use 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.