Probability of a cardiovascular event in the next decade.
Source: D'Agostino et al., Circulation 2008 — general CVD risk score.
What does the Framingham risk score mean?
The Framingham Risk Score estimates your probability of experiencing a major cardiovascular event, including coronary heart disease, stroke, peripheral artery disease, or heart failure, within the next 10 years. It was derived from data collected in the Framingham Heart Study, a longitudinal study of cardiovascular disease that began in Framingham, Massachusetts in 1948.
This calculator uses the 2008 general CVD risk score by D'Agostino and colleagues (Circulation 2008), which expanded the original coronary heart disease score to include all cardiovascular endpoints. Input variables include age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure treatment, smoking, and diabetes. Each factor receives a point score based on sex-specific regression coefficients derived from the study cohort.
The output is a percentage probability. A 15% score means that out of 100 people with the same risk profile, approximately 15 would be expected to have a cardiovascular event in the next 10 years. This does not mean you personally have a 15% chance, individual outcomes are not predictable; the score describes a population average.
Limitations include derivation from a predominantly White, American population and potential miscalibration in other populations. Factors not captured by the score, family history, C-reactive protein, coronary calcium score, can meaningfully modify risk at the individual level.
Reference ranges
| Risk category | 10-year CVD risk | Typical recommendation |
|---|---|---|
| Low | < 10% | Lifestyle optimisation; statins generally not indicated |
| Intermediate | 10 – 20% | Shared decision-making; consider statins |
| High | > 20% | Statin therapy and aggressive risk factor management |
When should you see a doctor?
Anyone with a Framingham risk above 10% should discuss results with their doctor. Even a "low risk" result does not mean no risk, it means risk from these factors alone is relatively low. If you have a strong family history of premature heart disease, have had blood markers such as elevated CRP, or have had a coronary artery calcium scan showing calcification, your actual risk may be higher than the score suggests.
Frequently asked questions
What does the Framingham risk score measure?
The Framingham Risk Score estimates the probability that a person will have a cardiovascular event (heart attack, stroke, heart failure, or peripheral artery disease) in the next 10 years. It was derived from the long-running Framingham Heart Study and uses age, sex, total cholesterol, HDL cholesterol, systolic blood pressure (and whether it is treated), smoking status, and diabetes to calculate risk.
What is considered high Framingham risk?
A 10-year cardiovascular risk below 10% is generally considered low risk. A risk of 10–20% is intermediate risk. A risk above 20% is classified as high risk, at which point most guidelines recommend statin therapy and aggressive lifestyle modification regardless of absolute cholesterol levels.
How accurate is the Framingham risk score?
The Framingham score was derived from a predominantly White, middle-class, American population and may overestimate or underestimate risk in other ethnic groups and modern populations with better overall risk factor control. More recent scores such as the ACC/AHA Pooled Cohort Equations and SCORE2 (Europe) attempt to address these limitations, but all risk scores have inherent uncertainty at the individual level.