What is the Framingham Risk Score?

The Framingham Risk Score estimates the 10-year risk of developing cardiovascular disease (coronary heart disease, stroke, peripheral artery disease, or heart failure) based on age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for hypertension, smoking, and diabetes.

How does the Framingham score differ from the ASCVD calculator?

The Framingham Risk Score predicts total cardiovascular disease events (including heart failure and PAD), while the ASCVD Pooled Cohort Equations predict only atherosclerotic events (MI and stroke). Framingham was derived from a predominantly White population; the ASCVD calculator includes data from African American cohorts.

What Framingham risk level requires treatment?

Low risk: 20%. Treatment decisions (particularly statin initiation) now primarily use the ASCVD calculator per ACC/AHA guidelines, but Framingham remains useful for overall cardiovascular risk communication and international guidelines.

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Framingham 10-Year CV Risk Score

Estimate 10-year risk of developing coronary heart disease (CHD) using the 2002 ATP III Framingham point-based algorithm.

Eingaben

Geschlecht

Age (years, 20–79)

Total cholesterol (mg/dL)

HDL cholesterol (mg/dL)

Systolischer Blutdruck (mmHg)

Blutdruckbehandlung?

Current smoker

Diabetes

—

Enter all values above.

Point total—

Risk category—

Disclaimer: For educational purposes only. The Framingham score was derived primarily from a white American cohort and may under- or over-estimate risk in other populations. Consider PCE (Pooled Cohort Equations) for broader populations.

About

Uses the 2002 ATP III point-based Framingham algorithm for 10-year CHD risk.
Validated for ages 20–79 (best 30–74).
Separate scoring tables for men and women.

Risk thresholds

< 10%: Low risk
10–20%: Intermediate risk
> 20%: High risk — consider statin therapy equivalent to secondary prevention

Clinical pearls

ATP III guidelines used this score to guide LDL targets and statin initiation.
2013 ACC/AHA shifted to the Pooled Cohort Equations (ASCVD risk), but Framingham remains widely recognized.
Risk-enhancing factors (family history, CRP, CAC score, ankle-brachial index) can refine risk estimates.

References

Wilson PWF, et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–1847.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III). JAMA. 2001;285(19):2486–2497.

Related tools

Über dieses Tool

Was ist der Framingham-Risikoscore?

The Framingham Risk Score (FRS) is a sex-specific, multivariable risk assessment tool derived from the Framingham Heart Study that estimates the 10-year risk of developing coronary heart disease (CHD). The ATP III (2001) version uses age, total cholesterol, HDL cholesterol, systolic blood pressure (with treatment status), smoking, and diabetes to calculate separate point totals for men and women that map to a 10-year CHD risk percentage.

When to Use the Framingham Risk Score

Calculate the FRS in adults aged 20–79 without established atherosclerotic cardiovascular disease (ASCVD) to guide primary prevention decisions, particularly regarding statin therapy initiation and LDL-C treatment targets. While the 2013 ACC/AHA guidelines replaced Framingham with the Pooled Cohort Equations (PCE) for ASCVD risk estimation, the Framingham score remains widely recognized and is still used in many clinical contexts internationally.

Interpreting Framingham Results

FRS categorizes patients into low (<10%), intermediate (10–20%), and high (>20%) 10-year CHD risk. High-risk patients may benefit from aggressive lipid lowering, and diabetes is considered a CHD risk equivalent in ATP III (regardless of calculated score). Intermediate-risk patients may benefit from additional risk assessment using coronary artery calcium (CAC) scoring, hs-CRP, or ankle-brachial index.

🔑 Klinische Hinweise

The FRS was derived primarily from a white American cohort and may underestimate risk in South Asian, Black, and Hispanic populations, or overestimate risk in East Asian populations.
The 2018 ACC/AHA cholesterol guideline recommends the Pooled Cohort Equations (PCE) for ASCVD risk estimation. Consider using both if results diverge.
Family history of premature CHD (first-degree relative: men <55, women <65) is a significant risk enhancer not captured by the FRS. Factor it into clinical decision-making.
Coronary artery calcium (CAC) score of 0 can reclassify intermediate-risk patients to lower risk, potentially deferring statin therapy.

Wichtige Referenzen

Wilson PWF, et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–1847.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III). JAMA. 2001;285(19):2486–2497.
Grundy SM, et al. 2018 AHA/ACC/AACVPR Guideline on the Management of Blood Cholesterol. J Am Coll Cardiol. 2019;73(24):e285–e350.

Formel zuletzt überprüft: Februar 2026