Cardiology

Framingham Risk Score

10-year cardiovascular disease risk estimate using the Framingham Heart Study equation. Includes statin decision support and ACC/AHA risk category interpretation.

Framingham Heart Study 10-year CVD risk PDF export
Framingham Risk Score
yrs
Valid range: 30-79 years. Enter age 30-79.
mmol/L
Enter a valid total cholesterol.
mmol/L
Enter a valid HDL.
mmHg
Enter a valid SBP (80-250 mmHg).
Framingham Result
-
-
10-year cardiovascular disease risk

Risk categories:

<10%
Low
Lifestyle focus
10-20%
Intermediate
Statin if LDL >3.0
>20%
High
Statin recommended

The Framingham Risk Score

The Framingham Heart Study has tracked residents of Framingham, Massachusetts since 1948. The risk equation derived from this cohort was one of the first tools to translate individual risk factors into a 10-year probability of cardiovascular events (coronary heart disease, stroke, peripheral artery disease). The study is run by the NHLBI in partnership with Boston University, and its risk calculators remain freely available for clinical and public use.

It uses age, sex, total cholesterol, HDL cholesterol, systolic BP (and whether it's treated), diabetes, and smoking. Each factor is scored using sex-specific coefficients, summed, and mapped to a 10-year event probability. If your cholesterol results came back in different units than this form expects, our Lab Values Converter handles mmol/L and mg/dL conversions for cholesterol and other common labs.

Risk categories and treatment thresholds

10-Year RiskCategoryTreatment Approach
<10%LowLifestyle modification. Statins if LDL very high or familial hypercholesterolaemia suspected.
10-20%IntermediateLifestyle modification strongly recommended. Statin if LDL >3.0 mmol/L or other high-risk features (CKD, family history).
>20%HighStatin therapy recommended for most. BP treatment target <130/80 mmHg. Aspirin low-dose in selected patients.

Body weight is one of the few risk factors in this equation's underlying cohort that a patient can meaningfully change; checking your BMI alongside this score can help frame which lifestyle changes matter most.

Framingham vs QRISK vs ACC/AHA PREVENT Equations

The Framingham equation was derived from a predominantly white, middle-class US cohort. QRISK3 (used in UK NHS) includes additional factors like deprivation, ethnicity, atrial fibrillation, and systemic autoimmune disease. In the US, the 2026 ACC/AHA dyslipidemia guideline now recommends the newer PREVENT-ASCVD equations in place of the older Pooled Cohort Equations, since PREVENT is race-free, incorporates kidney function, and was validated on a much larger and more contemporary cohort. All of these tools produce broadly similar risk estimates but differ in population representativeness and how current their underlying guidance is.

Related tools

For ACS risk in chest pain presentation, see HEART Score. For QTc monitoring on statins or antihypertensives, see QTc Calculator.

References

  • Wilson PW, et al. "Prediction of coronary heart disease using risk factor categories." Circulation. 1998;97(18):1837-1847.
  • D'Agostino RB, et al. "General cardiovascular risk profile for use in primary care." Circulation. 2008;117(6):743-753.
  • Grundy SM, et al. "2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol." JACC. 2019;73(24):e285-350. Superseded by the 2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia.
Note: The Framingham equation estimates population-level risk and has known limitations in non-white populations and outside North America. All cardiovascular risk decisions must incorporate the full clinical picture and shared decision-making with the patient.