Framingham Risk Score

Estimates 10-year risk of heart disease based on specific cardiovascular risk factors.

In the text below the calculator you can read more about the scoring method and result interpretation.


The Framingham risk score calculator is based on a series of known cardiovascular risk factors that can indicate the 10-year risk of a patient to develop heart disease, especially coronary heart disease.

The risk factors have been identified during the Framingham Heart Study and include patient age and gender, hypertensive status, cholesterol determination and systolic pressure.


These are the possible Framingham scores and their associated cardiac risk percentages:

Female results Male results
Points Risk percentage Points Risk percentage
<0 0% <0 0%
0 - 8 <1% 0 <1%
9 - 12 1% 1 - 4 1%
13 - 14 2% 5 - 6 2%
15 3% 7 3%
16 4% 8 4%
17 5% 9 5%
18 6% 10 6%
19 8% 11 8%
20 11% 12 10%
21 14% 13 12%
22 17% 14 16%
23 22% 15 20%
24 27% 16 25%
≥25 >30% ≥17 >30%

Gender:*
Age:*
Total cholesterol (mg/dL):*
HDL cholesterol (mg/dL):*
Under hypertension treatment?*
Systolic blood pressure (mmHg):*
Smoker?*
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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


 

Framingham risk score explained

As a heart disease risk predictor, the Framingham score accounts for readily available patient data, cholesterol determinations and blood pressure, parameters that can offer an insight into the patient’s cardiovascular function.

The criteria are segmented by gender when calculating the final score. The risk predictor can be used for patients starting at 20 years of age, just to cover all risks, despite cardiac risk being proportional with patient age.

Total cholesterol values between 200 and 239 mg/dL are considered to carry borderline high risk whilst all values above 240 mg/dL carry high risk.

HDL cholesterol or the “good cholesterol” consists of high density lipoproteins that don’t stick to the arteries therefore do not form plaque or lead to atherosclerosis like low density lipoproteins (LDL) does.

HDL is also able to decrease part of circulating LDL. HDL values above 60 mg/dL are considered to protect against cardiovascular disease.

Hypertensive patients tend to be at higher risk of coronary artery disease (atherosclerosis). In the model, hypertension treatment is considered to lower this risk.

Systolic blood pressure, with the normal range between 90 and 120 mmHg, accounts for the force of contraction that pushes blood into circulation.

Smokers are at higher risk of angina, heart attack or stroke than non-smokers due to damage of the arterial lining, which leads to atheroma (narrowing arteries).

The answers that are input in the calculator are interpreted according to the range of values they belong to, and weigh differently in the final score.

It is important to note that there are separate values for males and females. The scorings are all explained in the tables below:

Age Female pts Male pts
20 - 34 -7 -9
35 - 39 -3 -4
40 - 44 0 0
45 - 49 3 3
50 - 54 6 6
55 - 59 8 8
60 - 64 10 10
65 - 69 12 11
70 - 74 14 12
≥75 16 13
Total cholesterol mg/dL
Value Female pts Male pts
Age interval: 20 - 39
<160 0 0
160 - 199 4 4
200 - 239 8 7
240 - 279 11 9
≥280 13 11
Age interval: 40 - 49
<160 0 0
160 - 199 3 3
200 - 239 6 5
240 - 279 8 6
≥280 10 8
Age interval: 50 - 59
<160 0 0
160 - 199 2 2
200 - 239 4 3
240 - 279 5 4
≥280 7 5
Age interval: 60 - 69
<160 0 0
160 - 199 1 1
200 - 239 2 1
240 - 279 3 2
≥280 4 3
Age interval: ≥70
<160 0 0
160 - 199 1 0
200 - 239 1 0
240 - 279 2 1
≥280 2 1
HDL cholesterol mg/dL
Value Female pts Male pts
≥60 -1 -1
50 - 59 0 0
40 - 49 1 1
<40 2 2
SBP mmHg / treated
Value Female pts Male pts
<120 0 0
120 - 129 3 1
130 - 139 4 2
140 -159 5 2
≥160 6 3
SBP mmHg / untreated
Value Female pts Male pts
<120 0 0
120 - 129 1 0
130 - 139 2 1
140 -159 3 1
≥160 4 2
Smoking (if yes)
Age Female pts Male pts
20 - 39 9 8
40 - 49 7 5
50 - 59 4 3
60 - 69 2 1
≥70 1 1
Smoking (if no) 0 pts
 

Result interpretation

The Framingham risk predictor result is easy to interpret based on the following table that awards the heart disease risk in percentage, for the whole variety of possible results, for each gender:

Female results Male results
Points Risk percentage Points Risk percentage
<0 0% <0 0%
0 - 8 <1% 0 <1%
9 - 12 1% 1 - 4 1%
13 - 14 2% 5 - 6 2%
15 3% 7 3%
16 4% 8 4%
17 5% 9 5%
18 6% 10 6%
19 8% 11 8%
20 11% 12 10%
21 14% 13 12%
22 17% 14 16%
23 22% 15 20%
24 27% 16 25%
≥25 >30% ≥17 >30%
 

About the study

The Framingham risk score was created by Wilson et al. in 1998 following a study that examined the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with CHD risk.

A cohort of 2,489 men and 2,856 women with ages between 30 and 74 took part in the study. The follow up period was of 12 years.

The 383 men and 227 women who developed CHD during the follow up period were associated with high blood pressure and high total cholesterol, amongst other factors.

The score was meant to allow physicians to predict multivariate coronary heart disease risk in patients without overt CHD.

 

High risk of CHD

Individual cardiac risk can be variable during the patient’s life, meaning that healthy lifestyle choices can decrease it.

For example, quitting smoking, maintaining a healthy diet or regular exercise can decrease cardiac risk.

The opposite of the above healthy choices makes up some of the heart disease risk factors, along diabetes mellitus or family history of CHD.

The following table introduces four types of cardiovascular disease:

Group of disease Examples
Coronary heart disease (CHD) Myocardial infarction (MI)
Heart failure (HF)
Angina pectoris
Coronary death
Cerebrovascular disease Transient ischemic attack (TIA)
Stroke
Aortic disease Aortic atherosclerosis
Thoracic aortic aneurysm
Abdominal aortic aneurysm
Peripheral arterial disease Also known as peripheral vascular disease
 

Original source

Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation.1998; 97(18):1837-47.

Other references

1. Vasan RS, Sullivan LM, Wilson PW, Sempos CT, Sundström J, Kannel WB, Levy D, D'Agostino RB. Relative importance of borderline and elevated levels of coronary heart disease risk factors. Ann Intern Med. 2005; 142(6):393-402.

2. D'Agostino RB, Sr. Vasan RS, Pencina M.J, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008; 117(6): 743–753.


App Version: 1.0.1

Coded By: MDApp

Specialty: Cardiology

System: Cardiovascular

Objective: Risk Predictor

Type: Score

No. Of Items: 8

Year Of Study: 1998

Article By: Denise Nedea

Published On: May 4, 2017 · 02:10 PM

Last Checked: May 4, 2017

Next Review: May 4, 2018