Estimating Coronary Heart Disease (CHD) Risk Using Framingham Heart Study Prediction Score Sheets

This update of the 1991 Framingham coronary prediction algorithm provides estimates of total CHD risk (risk of developing one of the following: angina pectoris, myocardial infarction, or coronary disease death) over the course of 10 years. Separate score sheets are used for men and women and the factors used to estimate risk include age, blood cholesterol (or LDL cholesterol), HDL cholesterol, blood pressure, cigarette smoking, and diabetes mellitus. Relative risk for CHD is estimated by comparison to low risk Framingham participants.

In addition to score sheets for men and women, a sample score sheet is provided to illustrate how they can be used.

Users of this risk algorithm should be aware of several caveats:

  1. The risk estimating score sheets are only for persons without known heart disease.
  2. The Framingham Heart Study risk algorithm encompasses only coronary heart disease, not other heart and vascular diseases.
  3. The Framingham Heart Study population is almost all Caucasian. The Framingham risk algorithm may not fit other populations quite as well.
  4. For some of the sex-age groups in Framingham, the numbers of events are quite small. Therefore, the estimates of risk for those groups may lack precision.
  5. Other organizations are considering how the information from the Framingham risk algorithm, as well as other assessments of risk, might best be incorporated into clinical practice. As new information and guidelines become available, they will be added.
  6. The Framingham risk score estimates the risk of developing CHD within a 10-year time period. This risk score may not adequately reflect the long-term or lifetime CHD risk of young adults, which is: one in two for men and one in three for women.
  7. The presence of any CHD risk factor requires appropriate attention because a single risk factor may confer a high risk for CHD in the long run, even if the 10-year risk does not appear to be high.
  8. Since age is a prominent determinant of the CHD risk score, the 10-year hazards of CHD are, on average, high in older persons. This may over-identify candidates for aggressive interventions. Relative risk estimates (risk in comparison with low risk individuals) may be more useful than absolute risk estimates in the elderly.
  9. The score derived from this algorithm should not be used in place of a medical examination.

Source: Wilson PWF, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837-1847. [Abstract] [Article]

Information about the Format of the Score Sheet

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Adobe PDF file LDL Cholesterol Score Sheet for Men (11 K)               

Adobe PDF file LDL Cholesterol Score Sheet for Women (12 K)         

Adobe PDF file Total Cholesterol Score Sheet for Men (11 K)

Adobe PDF file Total Cholesterol Score Sheet for Women (11 K)

HTML fileSample Score Sheet

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