Cardiovascular Risk Framingham Calculator
The Framingham Heart Study 10-year coronary heart disease (CHD) risk score uses age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure treatment status, smoking, and diabetes to estimate the probability of a heart attack or coronary death in the next 10 years. It uses the point score method from Wilson et al. (1998), which assigns points for each risk factor and converts the sum to a 10-year risk percentage.
Framingham scoring method (Wilson et al., 1998)
Points assigned for: age, total cholesterol, HDL cholesterol,
systolic BP (untreated vs. treated), smoking, diabetes.
10-year risk = sex-specific lookup of total points.
This calculator uses the point scoring tables from Wilson PW et al. (1998) Circulation, which assign points for each risk factor based on the observed coronary event rates in the Framingham cohort. The total points are converted to a 10-year CHD risk percentage using the published conversion tables.
Risk categories and clinical guidance
- Low risk: 10-year CHD risk below 10%
- Intermediate risk: 10-year CHD risk 10-20%
- High risk: 10-year CHD risk above 20%
- High-risk patients benefit from intensive lifestyle modification and statin therapy per AHA/ACC guidelines
Framingham risk calculator: frequently asked questions
What is the Framingham Risk Score?
The Framingham Risk Score (FRS) is a validated algorithm developed from the Framingham Heart Study, a long-running prospective cohort study in Massachusetts. It estimates the 10-year probability of a major coronary heart disease (CHD) event (heart attack or coronary death) based on age, sex, total cholesterol, HDL cholesterol, systolic blood pressure and treatment status, smoking status, and diabetes status.
What risk factors are included in the Framingham score?
The Wilson 1998 Framingham scoring system uses: age (different point tables for men and women), total cholesterol, HDL cholesterol, systolic blood pressure (with separate points for treated vs. untreated hypertension), current smoking status, and diabetes mellitus. Points are summed and converted to a 10-year CHD risk percentage using sex-specific probability tables.
What does a 10-year CHD risk percentage mean?
A 10-year CHD risk of 10% means that out of 100 people with the same risk profile, approximately 10 would be expected to experience a major coronary event (myocardial infarction or CHD death) within the next 10 years. Risk categories: below 10% is low risk; 10-20% is intermediate risk; above 20% is high risk. The ACC/AHA 2013 guidelines expanded this to include pooled cohort equations covering a broader range of atherosclerotic cardiovascular disease events.
How does the Framingham score differ from the ACC/AHA Pooled Cohort Equation?
The Framingham score estimates risk of coronary events (heart attack and coronary death) in a predominantly white population. The ACC/AHA 2013 Pooled Cohort Equations estimate risk of all atherosclerotic cardiovascular disease (ASCVD) events including stroke, and were derived from more racially diverse US cohort studies. For US clinical practice, the ACC/AHA equations are now preferred, but the Framingham score remains widely recognized and cited.
What risk score threshold triggers statin therapy?
According to the 2013 ACC/AHA Cholesterol Guidelines, statin therapy is recommended in adults with a 10-year ASCVD risk of 7.5% or above, no diabetes, LDL-C 70-189 mg/dL, and age 40-75 years. The Framingham 20% threshold for high risk was the older clinical trigger. Clinicians now typically use the ACC/AHA Pooled Cohort Equation and discuss risk with patients in a shared decision-making conversation.
Official sources
- Wilson PWF, et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837-1847. Available via PubMed 9603539.
- National Heart, Lung, and Blood Institute: Cardiovascular Disease Risk.
Reviewed by the CalculatorHub team, edited by James Graham, 14 June 2026. See our methodology.