Cardiovascular Risk Calculator

1. Enter sex and age. The equation covers ages 30 to 74. The tool shows an error outside that range.
2. Enter your test results. Type total cholesterol and HDL cholesterol in mg/dL, and your systolic blood pressure in mm Hg. Use recent values measured by a clinic or lab.
3. Answer the three yes or no questions. Blood pressure treatment, current smoking and diabetes each change the result.

mmol/L values need converting to mg/dL first. Ask your lab for mg/dL figures if your report shows mmol/L.

Cardiovascular risk is the probability that a person develops cardiovascular disease within a set time. This calculator reports the 10-year risk of a first event.

The equation counts a broad set of events. The Framingham Heart Study lists them as coronary death, heart attack, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease and heart failure. That list is wider than heart attack and stroke alone, so results run higher than scores that count fewer events.

The equation comes from D'Agostino and colleagues, published in Circulation in 2008. They followed 8,491 Framingham participants aged 30 to 74 who were free of cardiovascular disease. Over 12 years, 1,174 of them had a first event.

A risk score is not a diagnosis. It describes how often an event happened in a group of people with similar numbers. It cannot say what will happen to one person.

The calculator applies a Cox proportional-hazards equation with one set of coefficients for women and one for men.

1. Take natural logs. Age, total cholesterol, HDL and systolic pressure enter the sum as natural logarithms.
2. Pick the pressure coefficient. Treated blood pressure uses the larger coefficient.
3. Add smoking and diabetes. Each adds its coefficient when the answer is yes.
4. Convert to risk. Subtract the mean, take the exponential, raise S0 to that power and subtract from 1.

The values in the table match Table 2 of the paper and the Framingham Heart Study risk-function page.

The paper works through a 61-year-old woman. She has total cholesterol 180 mg/dL, HDL 47 mg/dL and untreated systolic pressure 124 mm Hg. She smokes and does not have diabetes.

1. 2.32888 x ln(61) = 9.57.
2. 1.20904 x ln(180) = 6.28.
3. -0.70833 x ln(47) = -2.73.
4. 2.76157 x ln(124) = 13.31.
5. Smoking adds 0.52873. The sum is 26.9653.
6. exp(26.9653 - 26.1931) = 2.1646.
7. Risk = 1 - 0.95012 ^ 2.1646 = 10.5 percent.

The paper reports the same 10.5 percent, and 6.7 percent for a 61-year-old woman with the normal profile. Her risk is 1.58 times normal.

The second case in the paper is a 53-year-old man with treated systolic pressure 125, total cholesterol 161, HDL 55 and diabetes, who does not smoke. The equation gives 15.6 percent, against 9.1 percent for the normal profile, and a heart age of 64. This calculator returns those figures. Both cases are loaded as presets.

One difference is expected. The paper reads the woman's heart age as 73 from its points table. Solving the equation directly gives 75, which is the figure this tool shows.

Every input moves the result. The examples start from a 55-year-old man with total cholesterol 213, HDL 50 and untreated systolic pressure 120, who does not smoke and has no diabetes. His risk is 10.2 percent.

Age

Age has the largest coefficient. The same man scores 5.7 percent at 45 and 16.5 percent at 65.

Sex

A 55-year-old woman with the same numbers scores 5.3 percent.

Smoking

Answering yes raises his result from 10.2 to 18.8 percent, and his heart age from 55 to 68.

Diabetes

Answering yes raises his result to 17.4 percent.

Blood Pressure and Treatment

A systolic pressure of 140 instead of 120 gives 13.5 percent. The same 140 on treatment gives 18.2 percent. The paper fits separate coefficients for treated and untreated pressure. The higher treated value does not mean treatment is harmful.

HDL Cholesterol

HDL has a negative coefficient, so a lower value raises risk. An HDL of 35 instead of 50 gives 14.0 percent.

Risk scores differ in the events they count and the people they were built on, so their results are not interchangeable.

The Framingham Heart Study website now recommends the 2018 ACC/AHA prevention guidelines tool, based on the pooled cohort equations, for estimating atherosclerotic risk. Ask your doctor which score applies to you.

The paper also offers a simpler model that swaps cholesterol for body mass index. This page uses the lipid model only.

Preparing for a Checkup

Bring your numbers and the result to your appointment. The risk band is a starting point for a conversation, not a decision.

Seeing How Risk Factors Combine

Change one input at a time to see its effect in the equation. Students of medicine and public health use the tool this way.

Checking a Hand Calculation

The coefficient table and worked example let you verify a spreadsheet or coursework answer.

Tracking the Inputs, Not the Score

Blood pressure, cholesterol and weight are worth following over time. The ideal weight calculator and the VO2 max calculator cover two related measures.

1. Reading the Result as a Diagnosis

A 10 percent result does not mean disease is present. It means about 10 in 100 similar people in the study group had an event within 10 years.

2. Using It After a Heart Attack or Stroke

The equation was built on people without cardiovascular disease. It does not apply once disease exists.

3. Entering Mmol/L Values

The equation expects mg/dL. A total cholesterol of 5.2 is an mmol/L figure and will show an error.

4. Typing the Lower Blood Pressure Number

The equation uses systolic pressure, the upper number.

5. Comparing with a Different Score

A score that counts fewer events gives a lower percent for the same person. Compare like with like.

6. Changing Medicine Because of the Number

Treatment decisions belong with your doctor, who sees your full history. Regular activity is one habit to discuss; the exercise calorie calculator shows the energy an activity uses.

The calculator reproduces the published equation exactly. In the original study the equation separated people who had events from those who did not with a C statistic of 0.763 in men and 0.793 in women.

This is not a diagnosis. See a clinician to interpret any result, and seek urgent care for symptoms such as chest pain.

The 2008 Framingham paper treats a 10-year risk over 20 percent as high. It used under 6 percent, 6 to 20 percent and over 20 percent as its three bands.

Adults aged 30 to 74. The equation was derived from people in that age range, and the tool gives no score outside it.

Heart age is the age of a person with normal risk factor levels who has the same 10-year risk as you. A 53-year-old man with a 15.6 percent risk has a heart age of 64.

The treated coefficient is larger. At the same reading, people on treatment in the study group had more events than untreated people. It is not a reason to stop treatment.

No. The ASCVD pooled cohort equations count heart attack, coronary death and stroke. This equation counts more event types, so its results are usually higher.

Not directly. The equation expects mg/dL. Convert your values or ask your lab for mg/dL figures before using the tool.

No. A low score means a lower estimated chance of an event over 10 years. It does not rule out disease, and it ignores factors such as family history.

No. The study group was predominantly white and lived in one US town. The authors state that the function should be tested, and sometimes recalibrated, in other populations.

People who already have heart disease, stroke or peripheral artery disease should not use it. It also does not apply to anyone under 30 or over 74.

No. The math runs in your browser. The Save button keeps results only in your own browser storage.

• Cardiovascular disease 10-year risk function: coefficients, population and outcome (Framingham Heart Study, Boston University).
• General cardiovascular risk profile for use in primary care: the Framingham Heart Study (D'Agostino RB and others, Circulation, 2008; PubMed record).
• Coronary heart disease risk factors (National Heart, Lung, and Blood Institute).
• How to prevent heart disease (MedlinePlus, US National Library of Medicine).