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    Framingham Risk Score for Hard Coronary Heart Disease

    Estimates 10-year risk of heart attack.
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    INSTRUCTIONS

    There are several distinct Framingham risk models. MDCalc uses the 'Hard' coronary Framingham outcomes model, which is intended for use in non-diabetic patients age 30-79 years with no prior history of coronary heart disease or intermittent claudication, as it is the most widely applicable to patients without previous cardiac events. See the official Framingham website for additional Framingham risk models.

    When to Use
    Pearls/Pitfalls
    • Patients aged 30-79 years with no prior history of coronary heart disease.
    • Do not use in patients with intermittent claudication or diabetes.
    The Framingham data, while thorough, come from many years ago with a potentially different US population along with a different diet and level of smoking as well, which may suggest different risk levels today.
    years
    Female
    Male
    No
    Yes
    mg/dL
    mg/dL
    mm Hg
    No
    Yes

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    Patients with high risk scores should be counseled aggressively about social factors contributing to their risk (smoking, exercise, weight, diet, etc) and also managed with blood pressure and lipid evaluation.

    Formula

    Equations as follows (β coefficients listed in table below):

    Men:

    LMen = β x ln(Age) + β x ln(Total cholesterol) + β x ln(HDL cholesterol) + β x ln(Systolic BP) + β x Treated for blood pressure + β x Smoker + β x ln(Age) x ln(Total cholesterol) + β x ln(Age) x Smoker + β x ln(Age) x ln(Age) - 172.300168

    PMen = 1 - 0.9402^exp(LMen)

    Women:

    LWomen = β x ln(Age) + β x ln(Total cholesterol) + β x ln(HDL cholesterol) + β x ln(Systolic BP) + β x Treated for blood pressure + β x Smoker + β x ln(Age) x ln(Total cholesterol) + β x ln(Age) x Smoker - 146.5933061

    PWomen = 1 - 0.98767^exp(AWomen)

    Variable

    Coefficient (β)

    Men

    Women

    ln(Age)

    52.00961

    31.764001

    ln(Total cholesterol)

    20.014077

    22.465206

    ln(HDL cholesterol)

    -0.905964

    -1.187731

    ln(Systolic BP)

    1.305784

    2.552905

    Treated for blood pressure*

    0.241549

    0.420251

    Smoker*

    12.096316

    13.07543

    ln(Age) x ln(Total cholesterol)

    -4.605038

    -5.060998

    ln(Age) x Smoker**

    -2.84367

    -2.996945

    ln(Age) x ln(Age)

    -2.93323

    -

    *Yes = 1, No = 0.

    **Men: if age >70, use ln(70) x Smoker. Women: if age >78, use ln(78) x Smoker.

     

    Facts & Figures

    Interpretation:

    Age, years

    Average 10 year hard* CHD risk in this patient

    Low** 10 year CHD risk in the average patient

    Women

    Men

    Women

    Men

    30-34

    <1%

    1%

    <1%

    2%

    35-39

    <1%

    4%

    1%

    3%

    40-44

    1%

    4%

    2%

    4%

    45-49

    2%

    8%

    3%

    4%

    50-54

    3%

    10%

    5%

    6%

    55-59

    7%

    13%

    7%

    7%

    60-64

    8%

    20%

    8%

    9%

    65-69

    8%

    22%

    8%

    11%

    70-74

    11%

    25%

    8%

    14%

    74-79

    Data not available

    Data not available

    Data not available

    Data not available

    *Excluding angina pectoris.

    **Low risk was calculated for a person the same age, optimal blood pressure, LDL-C 100-129 mg/dL or cholesterol 160-199 mg/dL, HDL-C 45 mg/dL for men or 55 mg/dL for women, non-smoker, no diabetes.

     

    Dr. Peter W.F. Wilson

    About the Creator

    Peter W. F. Wilson, MD, is professor of medicine in the cardiology division of Emory University and a professor of public health at the Rollins School of Public Health. He is currently the director of epidemiology and genomic medicine at the Atlanta VA Medical Center. Dr. Wilson researches metabolic and cardiovascular population issues, focusing on determinants of CAD, including diabetes mellitus, hormonal factors, inflammatory markers, and genetics.

    To view Dr. Peter W.F. Wilson's publications, visit PubMed

    About the Creator
    Dr. Peter W.F. Wilson