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:
- The risk estimating score sheets are only for persons without known heart
- The Framingham Heart Study risk algorithm encompasses only coronary heart
disease, not other heart and vascular diseases.
- The Framingham Heart Study population is almost all Caucasian. The Framingham
risk algorithm may not fit other populations quite as well.
- 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.
- 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.
- 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
- 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.
- 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
- 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]
Information about the Format of the Score Sheet
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LDL Cholesterol Score Sheet for Men (11 K)
LDL Cholesterol Score Sheet for Women (12 K)
Total Cholesterol Score Sheet for Men (11 K)
Total Cholesterol Score Sheet for Women (11 K)
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