Framingham Heart Attack Risk Calculator
The
heart attack risk calculator below uses recent data from the
Framingham Heart Study to estimate the 10-year risk for myocardial infarction and coronary death. The calculator is designed for adults aged 20 and older who do not have heart disease or diabetes and is based on the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
- Adult Treatment Panel or ATP III.
If you are a woman, please use the Reynolds risk score calculator, as it is a more accurate method of predicting your risk of a heart attack or stroke.
Calculate Your 10-Year Risk of A Heart Attack
Please use the calculator below to estimate your 10-year risk of a heart attack or coronary death.
Instructions & Glossary of Terms
Total Cholesterol
This is the total amount of cholesterol in the blood. The higher your total cholesterol, the greater your risk for heart disease.
HDL Cholesterol
HDL cholesterol makes up almost one third of the total blood cholesterol. It's name comes from the carrier
high-density lipoprotein (
HDL). It is considered a "good" form or cholesterol because, when present in higher levels, it protects against heart disease. Conversely, lower levels (less than 40 mg/dL) increase the risk of heart disease. It may seem strange that cholesterol protects, but think of it this way: HDL cholesterol acts as a cleaner, carrying cholesterol away from the arteries back to the liver, which in turn removes it from the body.
In reality, it is the
LDL cholesterol (or "bad" cholesterol) that raises your risk of heart disease, but in the Framingham study database, due to the way data was collected, estimates are more reliable for total cholesterol than for LDL cholesterol.
Systolic Blood Pressure
Blood pressure readings are usually given as two numbers: for example, 120 over 70 (written as 120/70). The first number is the
systolic blood pressure reading, and it represents the maximum pressure exerted when the heart contracts. Optimal blood pressure is 120/80 or less.
Smoker
Select "Yes" if you smoked any cigarette in the past month.
How Is My Heart Attack Risk Calculated?
The formula used to calculate your heart attack risk is based on a scoring system taken from the ATP III recommendations, which in turn are based on the Framingham Heart Study.
ATP III Update
In the July 2004 issue of the Journal Circulation, an important
update to the ATP III recommendations was published, based on findings from recent clinical trials for the National Cholesterol Education Program. These are landmark recommendations that are right now changing medical practice in America.
The new guidelines, based on the 10-year risk of a heart attack, are summarized in the table below.
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ATP III LDL-Cholesterol Goals and Cutpoints for Therapeutic Lifestyle Changes (TLC) and Drug Therapy in Different Risk Categories
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Risk Category
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LDL-Cholesterol Goal
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Initiate TLC
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Consider Drug Therapy
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High risk: CHD* or CHD risk equivalents†
(10-year risk >20%)
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<100 mg/dL
(optional goal: <70 mg/dL)||
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>=100 mg/dL#
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>=100 mg/dL††
(<100 mg/dL: consider drug options)**
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Moderately high risk: 2+ risk factors‡
(10-year risk 10% to 20%)
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<130 mg/dL¶
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>=130 mg/dL#
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>=130 mg/dL
100–129 mg/dL; consider drug options)‡‡
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Moderate risk: 2+ risk factors‡
(10-year risk <10%)
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<130 mg/dL
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>=130 mg/dL
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>=160 mg/dL
|
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Lower risk: 0–1 risk factor§
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<160 mg/dL
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>=160 mg/dL
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>=190 mg/dL
(160–189 mg/dL: LDL-lowering drug optional)
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Legend
* CHD includes history of myocardial infarction, unstable angina, stable angina, coronary artery procedures (angioplasty or bypass surgery), or evidence of clinically significant myocardial ischemia.
† CHD risk equivalents include clinical manifestations of noncoronary forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, carotid artery disease [transient ischemic attacks or stroke of carotid origin or >50% obstruction of a carotid artery]), diabetes, and 2+ risk factors with 10-year risk for hard CHD >20%.
‡ Risk factors include cigarette smoking, hypertension (BP >=140/90 mm Hg or on antihypertensive medication), low HDL cholesterol (<40 mg/dL), family history of premature CHD (CHD in male first-degree relative <55 years of age; CHD in female first-degree relative <65 years of age), and age (men >=45 years; women >=55 years).
§ Almost all people with zero or 1 risk factor have a 10-year risk <10%, and 10-year risk assessment in people with zero or 1 risk factor is thus not necessary.
|| Very high risk favors the optional LDL-C goal of <70 mg/dL, and in patients with high triglycerides, non-HDL-C <100 mg/dL.
¶ Optional LDL-C goal <100 mg/dL.
# Any person at high risk or moderately high risk who has lifestyle-related risk factors (eg, obesity, physical inactivity, elevated triglyceride, low HDL-C, or metabolic syndrome) is a candidate for therapeutic lifestyle changes to modify these risk factors regardless of LDL-C level.
** When LDL-lowering drug therapy is employed, it is advised that intensity of therapy be sufficient to achieve at least a 30% to 40% reduction in LDL-C levels.
†† If baseline LDL-C is <100 mg/dL, institution of an LDL-lowering drug is a therapeutic option on the basis of available clinical trial results. If a high-risk person has high triglycerides or low HDL-C, combining a fibrate or nicotinic acid with an LDL-lowering drug can be considered.
‡‡ For moderately high-risk persons, when LDL-C level is 100 to 129 mg/dL, at baseline or on lifestyle therapy, initiation of an LDL-lowering drug to achieve LDL-C level <100 mg/dL is a therapeutic option on the basis of available clinical trial results.
Dr Gily
