CVD Risk Calculator — 10-Year Cardiovascular Risk (Framingham)

Formula

How this is calculated

The Framingham Risk Score (FRS), published by Wilson et al. (2002) and endorsed by the NHLBI, uses six clinical variables — age, sex, total cholesterol, HDL cholesterol, systolic blood pressure (and whether it is being treated), current smoking, and diabetes — to assign a points total. Each variable contributes a different number of points depending on its value and the patient's age group, because the same cholesterol level or smoking habit is more dangerous at 40 than at 70 (risk differences narrow with age). The sum maps to a published 10-year risk percentage calibrated from decades of Framingham Heart Study follow-up data.

The tool divides risk into four clinical categories: Low (<5 %), Intermediate (5–10 %), High (10–20 %), and Very High (>20 %). In clinical practice, high-risk patients are typically offered statin therapy and more aggressive BP targets regardless of individual risk factor values, while intermediate-risk patients may benefit from shared decision-making including a coronary artery calcium (CAC) scan to guide treatment.

Important limitations: the FRS was developed in a largely white American population; it may slightly overestimate risk in some non-white groups or underestimate it in others. Newer tools such as the ACC/AHA Pooled Cohort Equations (2013) or SCORE2 (Europe, 2021) address some of this variation. This calculator is a screening tool only — treatment decisions must involve a clinician who can assess family history, lifestyle, imaging findings, and other contextual factors.