Framingham Risk Calculator (10-Year CVD Risk and Heart Age)
Estimate your 10-year risk of cardiovascular disease using the Framingham General CVD Risk Score from the Framingham Heart Study. Enter your age, sex, total and HDL cholesterol, systolic blood pressure, and whether you are treated for blood pressure, smoke, or have diabetes. You get your 10-year risk and risk band, your heart (vascular) age, a breakdown of what is driving the number, and a what-if showing the lower risk you could reach with optimal blood pressure, cholesterol and no smoking.
Formula
Worked example
A 61-year-old woman, total cholesterol 180, HDL 47, systolic BP 124 untreated, current smoker, no diabetes, gives a linear predictor that yields a 10-year CVD risk of about 10.5%, matching the published Framingham example.
What the Framingham Risk Score estimates
The Framingham General Cardiovascular Risk Score, published by D'Agostino and colleagues in 2008, estimates a person's probability of developing cardiovascular disease over the next 10 years. "Cardiovascular disease" here is broad: it includes coronary heart disease, stroke, peripheral artery disease, and heart failure. The score was built from decades of follow-up data in the Framingham Heart Study and is widely used in primary care for adults aged 30 to 74 who do not already have cardiovascular disease. It combines age, sex, total and HDL cholesterol, systolic blood pressure (and whether it is treated), smoking, and diabetes into a single percentage.
How the calculation works
Rather than a simple sum, the underlying model is a sex-specific Cox proportional-hazards equation. Each continuous risk factor (age, total cholesterol, HDL, and systolic blood pressure) enters on a natural-log scale, multiplied by a coefficient measured from the study population, and smoking and diabetes add fixed amounts. These are summed into a linear predictor, the population average is subtracted, and the result is exponentiated and combined with a baseline 10-year survival probability to give the final risk percentage. The printed Framingham point charts you may have seen are a rounded, paper-friendly version of this same equation; this calculator uses the continuous coefficients directly, so the result is more precise.
Reading your result
A common convention groups results into three bands: under 10% is considered low risk, 10% to 20% is intermediate, and above 20% is high. These bands help frame a conversation rather than dictate treatment. Two people with the same score can have very different overall pictures once family history, kidney function, additional lipid measures, and lifestyle are considered. Because cardiovascular risk is something you can change, the most useful next step is to look at which inputs are driving your number, blood pressure, cholesterol, and smoking are all modifiable, and discuss them with a clinician.
Heart age and the risk-factor breakdown
Heart age, also called vascular age, restates your risk as an age that is easier to feel. It is the age of a person with ideal risk factors (non-smoking, blood pressure around 125, total cholesterol near 180 and HDL near 45, no diabetes) whose 10-year risk matches yours. If your heart age is well above your real age, your risk factors are aging your arteries faster than the calendar. The breakdown table goes one step further and splits your risk into the part that comes from age and sex alone and the extra risk added by each modifiable factor, found by recomputing your score with that one factor reset to normal. Because these effects overlap in the equation, the pieces do not add up to the total exactly, but they show clearly where the biggest gains are.
The what-if: how much risk you can remove
Turn on the what-if to see the risk you could reach if you stopped smoking and brought blood pressure and cholesterol into the normal range, while keeping the things you cannot change such as age, sex and diabetes. The difference between your current risk and this achievable risk is the share that is within your control, and the age-versus-risk chart shows both curves side by side across two decades. This turns an abstract percentage into a concrete target you can take to a clinician, and it is why lowering blood pressure or quitting smoking often shifts the number more than people expect.
Framingham 10-year CVD risk bands
| 10-year risk | Category | General interpretation |
|---|---|---|
| Under 10% | Low | Lifestyle focus; routine follow-up |
| 10% to 20% | Intermediate | Discuss risk factors and possible treatment |
| Over 20% | High | Active risk-factor management usually warranted |
Risk categories commonly used with the Framingham General CVD Risk Score for primary prevention.
Frequently asked questions
Is the Framingham Risk Score still recommended?
It remains widely used and validated, especially in primary care. In the United States, the ACC/AHA Pooled Cohort Equations are now often preferred for guideline-based statin decisions, while many other countries continue to use Framingham or regional tools such as QRISK or SCORE2. All of these are screening estimates, not diagnoses.
What cholesterol numbers should I enter?
Use your total cholesterol and HDL ("good") cholesterol from a standard lipid panel. You can enter them in mg/dL (common in the US) or mmol/L (common internationally); the calculator converts at 38.67 mg/dL per mmol/L. If you do not have recent values, ask your doctor or use a recent blood test report.
What is heart age (vascular age)?
Heart age is the age of a person with ideal risk factors whose 10-year cardiovascular risk equals yours. If your heart age is higher than your real age, your blood pressure, cholesterol, smoking or diabetes are raising your risk above the ideal for your age. It is a way to make the percentage easier to relate to, and it comes from the same Framingham equation.
How does the what-if estimate work?
It recomputes your risk after resetting smoking, blood pressure and cholesterol to normal, healthy values while keeping age, sex and diabetes unchanged. The gap between your current risk and that achievable risk is the portion you can influence through lifestyle and treatment. It is an estimate of potential, not a promise, and real-world change depends on many factors.
Does this calculator replace medical advice?
No. The result is a statistical estimate for groups of people with similar risk factors and cannot predict what will happen to any one individual. It does not account for family history, kidney disease, inflammatory conditions, or other factors. Always discuss your cardiovascular risk and any treatment decisions with a qualified healthcare professional.