How does this Framingham risk score calculator work?
This is a health tool designed to estimate heart disease risk in individuals in a period of 10-years, especially that of coronary heart disease, based on a series of factors identified as cardiovascular risk factors in the Framingham Heart Study. It comprises of age, gender and whether the person scored is a smoker or not or under treatment for hypertension; plus three clinical determinations important in assessing cardiovascular function risks: total cholesterol, HDL cholesterol and systolic blood pressure.
The criteria considered in this Framingham risk score calculator is detailed below:
■ Gender - Male/Female, this factor is taken in consideration as the points in the following criteria are segmented by gender.
■ Age – this health calculator permits ages starting from 20 to ensure most individual cases of importance are covered, not only elderly people in which, of course, the heart disease risk is proportional to age.
■ Total cholesterol (mg/dL) – a lower TC than 200 mg/dL is considered low risk while 200 to 239 mg/dL is borderline high and everything above 240 mg/dL is high risk.
■ HDL cholesterol (mg/dL) – contrary to the general belief, not all cholesterol is bad cholesterol. HDL is considered the good one as it consists of high density lipoproteins that don’t stick to the arteries forming plaque and leading to atherosclerosis like LDL. Plus, HDL is also able to remove part of LDL, the bad cholesterol away from the arteries and is said to protect against heart attack and stroke when in levels higher than 60 mg/dL. Everything under 40mg/dL HDL is considered high risk for cardiovascular disease.
■ Under hypertension treatment - Yes/No – people with high blood pressure are at risk of coronary artery disease (atherosclerosis) and hypertension treatment can help lower the risk.
■ Systolic blood pressure (mmHg) - This is the first number in the blood pressure reading with the normal range between 90 and 120 mmHg and corresponds to the force with which the contraction of the heart pushes blood in circulation.
■ Smoker - Yes/No – smoking increases heart disease risk by damaging the arterial lining, leading to atheromas which are buildups narrowing the arteries, leading on the long term to very high risk of angina, heart attack or stroke.
The following tables are presenting the break down of criteria and points in the Framingham scoring model according to gender:
Age | Female pts | Male pts |
20 - 34 | -7 | -9 |
35 - 39 | -3 | -4 |
40 - 44 | ||
45 - 49 | 3 | 3 |
50 - 54 | 6 | 6 |
55 - 59 | 8 | 8 |
60 - 64 | 10 | 10 |
65 - 69 | 12 | 11 |
70 - 74 | 14 | 12 |
>75 | 16 | 13 |
Total cholesterol mg/dL | ||
Value | Female pts | Male pts |
Age interval: 20 - 39 | ||
<160 | ||
160 - 199 | 4 | 4 |
200 - 239 | 8 | 7 |
240 - 279 | 11 | 9 |
>=280 | 13 | 11 |
Age interval: 40 - 49 | ||
<160 | ||
160 - 199 | 3 | 3 |
200 - 239 | 6 | 5 |
240 - 279 | 8 | 6 |
>=280 | 10 | 8 |
Age interval: 50 - 59 | ||
<160 | ||
160 - 199 | 2 | 2 |
200 - 239 | 4 | 3 |
240 - 279 | 5 | 4 |
>=280 | 7 | 5 |
Age interval: 60 - 69 | ||
<160 | ||
160 - 199 | 1 | 1 |
200 - 239 | 2 | 1 |
240 - 279 | 3 | 2 |
>=280 | 4 | 3 |
Age interval: >70 | ||
<160 | ||
160 - 199 | 1 | |
200 - 239 | 1 | |
240 - 279 | 2 | 1 |
>=280 | 2 | 1 |
HDL cholesterol mg/dL | ||
Value | Female pts | Male pts |
>=60 | -1 | -1 |
50 - 59 | ||
40 - 49 | 1 | 1 |
<40 | 2 | 2 |
SBP mmHg / treated | ||
Value | Female pts | Male pts |
<120 | ||
120 - 129 | 3 | 1 |
130 - 139 | 4 | 2 |
140 -159 | 5 | 2 |
>=160 | 6 | 3 |
SBP mmHg / untreated | ||
Value | Female pts | Male pts |
<120 | ||
120 - 129 | 1 | |
130 - 139 | 2 | 1 |
140 -159 | 3 | 1 |
>=160 | 4 | 2 |
Smoking (if yes) | ||
Age | Female pts | Male pts |
20 - 39 | 9 | 8 |
40 - 49 | 7 | 5 |
50 - 59 | 4 | 3 |
60 - 69 | 2 | 1 |
> 70 | 1 | 1 |
Smoking (if no) 0 pts | ||
Framingham risk score – result interpretation
| Female results | Male results | ||
| Points | Risk percentage | Points | Risk percentage |
| <0 | 0% | <0 | 0% |
| 0 - 8 | <1% | 0 | <1% |
| 9 - 12 | 1% | 1 - 4 | 1% |
| 13 - 14 | 2% | 5 - 6 | 2% |
| 15 | 3% | 7 | 3% |
| 16 | 4% | 8 | 4% |
| 17 | 5% | 9 | 5% |
| 18 | 6% | 10 | 6% |
| 19 | 8% | 11 | 8% |
| 20 | 11% | 12 | 10% |
| 21 | 14% | 13 | 12% |
| 22 | 17% | 14 | 16% |
| 23 | 22% | 15 | 20% |
| 24 | 27% | 16 | 25% |
| >=25 | >30% | >=17 | >30% |
What if the score says I have a high risk of CHD?
The Framingham is a well reputed risk scoring system so these findings should be taken seriously. However, it is important to know that the individual cardiovascular risk is modifiable, meaning it can be decreased through lifestyle changes (quitting smoking, maintaining a healthy diet, exercising regularly) and/ or through preventive treatment (statin, aspirin doses, hypertension medication).
Cardiovascular disease
CVD is a term given to a class of diseases of the heart and blood vessels and includes:
1) Coronary heart disease (CHD)
- Myocardial infarction (MI)
- Heart failure (HF)
- Angina pectoris
- Coronary death
2) Cerebrovascular disease
- Transient ischemic attack (TIA)
- Stroke
3) Aortic disease
- Aortic atherosclerosis
- Thoracic aortic aneurysm
- Abdominal aortic aneurysm
4) Peripheral arterial disease
Other risk factors for heart disease
Along with the factors presented in the scoring above there are other lifestyle elements or health conditions deemed to increase heart disease incidence:
- Unhealthy diet
- Lack of exercise
- Family history
- Diabetes
References
1) D'Agostino RB, Sr. Vasan RS, Pencina M.J, Wolf PA, Cobain M, Massaro JM, Kannel WB. (2008) General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 117(6): 743–753.
2) Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. (1998) Prediction of coronary heart disease using risk factor categories. Circulation; 97(18):1837-47.
12 Jul, 2015
