What is the Framingham Risk Score?

The Framingham Risk Score refers to validated models from the Framingham Heart Study that estimate 10-year cardiovascular risk. Our calculator returns two scores: the 2008 General CVD Risk Score (D'Agostino et al.) for any major cardiovascular event — CHD, stroke, PAD, or heart failure — and the 1998 Hard CHD Risk Score (Wilson et al.) for coronary heart disease events only (angina, MI, coronary death).

What is the difference between General CVD and Hard CHD risk?

General CVD (2008) predicts CHD plus stroke, peripheral artery disease, and heart failure — it is broader and usually higher. Hard CHD (1998 Wilson) predicts coronary events only — angina, myocardial infarction, and coronary death. Hard CHD is the classic 'Framingham Risk Score' on MDCalc. Example: a 55-year-old man might show ~10% general CVD but ~6.5% hard CHD with the same inputs.

How is the General CVD risk score calculated?

The 2008 D'Agostino model uses sex-specific Cox coefficients. For men: Risk = 1 − 0.88936^exp(ΣβX − 23.9802). For women: Risk = 1 − 0.95012^exp(ΣβX − 26.1931). Inputs include log-transformed age, total cholesterol, HDL, systolic BP (treated vs untreated), plus binary smoking and diabetes.

How is the Hard CHD risk score calculated?

The 1998 Wilson model uses sex-specific equations with log age, total cholesterol, HDL, systolic BP, BP medication status, and smoking, plus age×cholesterol and age×smoking interaction terms (and age² for men). Baseline survival is 0.9402 for men and 0.98767 for women. Diabetes is not included in the Wilson hard CHD equation.

Who should use the Framingham risk calculator?

Adults aged 30–74 without established cardiovascular disease (no prior MI, stroke, PAD, heart failure, or revascularization). Both scores support primary prevention risk stratification and patient education. Not for patients on secondary-prevention therapy or with known CVD.

What are the Framingham risk categories?

Both general CVD and hard CHD use the same categories: Low risk < 10%; Intermediate risk 10% to < 20%; High risk ≥ 20%. Each score gets its own category label on your report. High risk on either score typically warrants aggressive intervention.

Why is my Hard CHD risk lower than my General CVD risk?

Hard CHD counts only coronary events (angina, MI, coronary death). General CVD also includes stroke, PAD, and heart failure — additional event types that raise the overall percentage. It is normal and expected for hard CHD to be equal to or lower than general CVD.

Does diabetes affect both Framingham scores?

Diabetes is included in the 2008 General CVD model and raises that score. The 1998 Wilson Hard CHD model does not include diabetes as an input. However, diabetes remains a major cardiovascular risk factor clinically — manage it aggressively regardless of the Wilson CHD score.

What is the difference between Framingham and ASCVD risk calculators?

Framingham General CVD predicts any first major cardiovascular event. Framingham Hard CHD predicts coronary events only. ASCVD Pooled Cohort Equations predict hard ASCVD events (nonfatal MI, coronary death, stroke) and are the preferred US tool for statin decisions per ACC/AHA guidelines.

Does Framingham use race or ethnicity?

No. Both Framingham models use sex-specific equations only — separate models for men and women. Unlike ASCVD PCE, there are no race-specific coefficients. Models were derived primarily from a White Framingham cohort and may not perfectly calibrate to all ethnic groups.

What cholesterol values should I enter?

Enter fasting total cholesterol and HDL cholesterol in mg/dL from your most recent lipid panel (within 12 months). Both general CVD and hard CHD use the same lipid values. Non-HDL cholesterol (Total − HDL) is computed automatically.

Should I enter treated or untreated blood pressure?

Enter your current systolic blood pressure and indicate whether you take BP medication. The 2008 general CVD model uses different coefficients for treated vs untreated SBP. The 1998 Wilson CHD model uses ln(SBP) plus a separate BP medication indicator.

Does smoking status matter?

Yes. Both Framingham models use current smoking status. Former smokers who quit more than 12 months ago are typically classified as non-smokers in clinical practice. Current smoking substantially raises both general CVD and hard CHD risk.

What is the difference between Framingham and the Cardiovascular Risk Calculator on this site?

Our Framingham calculator uses two validated formal Cox models — 2008 General CVD and 1998 Hard CHD. Our separate Cardiovascular Risk Calculator uses a simplified educational point score — it is NOT the Framingham model and cannot predict your exact 10-year event rate.

How accurate are the Framingham models?

The 2008 General CVD model showed C-statistic 0.763 (men) and 0.793 (women). The 1998 Wilson Hard CHD model is widely validated and matches MDCalc output. Both may over- or underestimate risk in non-White populations. Use alongside clinical judgment.

Can I use this calculator if I am under 30 or over 74?

Both models were validated for ages 30–74. This calculator enforces that range. For younger adults, lifetime risk assessment may be more informative. For ages 75+, clinical judgment dominates.

What events does General CVD predict vs Hard CHD?

General CVD (2008): CHD, stroke, PAD, and heart failure. Hard CHD (1998 Wilson): coronary heart disease only — angina, myocardial infarction, and coronary death. Hard CHD excludes stroke, PAD, and heart failure.

Is Framingham still used clinically?

Yes. General CVD (2008) is used for CDC Heart Age and total cardiovascular risk. Hard CHD (1998 Wilson) is the classic score on MDCalc and in historical ATP III guidelines. In the US, ASCVD PCE are preferred for statin therapy decisions per ACC/AHA.

What lifestyle changes lower Framingham risk?

Quit smoking, lower systolic BP, improve lipids (lower TC, raise HDL), manage diabetes, exercise 150+ min/week, maintain healthy weight, and follow a Mediterranean or DASH diet. Recalculate both general CVD and hard CHD after 3–6 months of sustained changes.

How does Framingham relate to Heart Age?

CDC Heart Age is based on the Framingham General CVD risk score (2008), not the Wilson hard CHD score. Your heart age is the age of a person with optimal risk factors who has the same 10-year general CVD risk as you.

Is this calculator a substitute for medical advice?

No. This calculator provides educational risk estimates from published Framingham equations for both general CVD and hard CHD. It does not diagnose disease, prescribe medication, or replace consultation with a qualified healthcare provider.

Framingham Risk Score Calculator

Q: Why is my Hard CHD risk lower than my General CVD risk?

Hard CHD counts only coronary events (angina, MI, coronary death). General CVD also includes stroke, PAD, and heart failure — additional event types that raise the overall percentage. It is normal and expected for hard CHD to be equal to or lower than general CVD.

Q: Does diabetes affect both Framingham scores?

Diabetes is included in the 2008 General CVD model and raises that score. The 1998 Wilson Hard CHD model does not include diabetes as an input. However, diabetes remains a major cardiovascular risk factor clinically — manage it aggressively regardless of the Wilson CHD score.

Q: What is the difference between Framingham and ASCVD risk calculators?

Framingham General CVD predicts any first major cardiovascular event. Framingham Hard CHD predicts coronary events only. ASCVD Pooled Cohort Equations predict hard ASCVD events (nonfatal MI, coronary death, stroke) and are the preferred US tool for statin decisions per ACC/AHA guidelines.

Q: Does Framingham use race or ethnicity?

No. Both Framingham models use sex-specific equations only — separate models for men and women. Unlike ASCVD PCE, there are no race-specific coefficients. Models were derived primarily from a White Framingham cohort and may not perfectly calibrate to all ethnic groups.

Free Framingham risk score calculator with two validated scores: 2008 General CVD risk (CHD, stroke, PAD, heart failure) and 1998 Hard CHD risk (angina, MI, coronary death) — from cholesterol, BP, smoking, diabetes, age, and sex, with risk categories and PDF export.

Enter your details — results appear below after you calculate.

Demographics

Age (years)

Framingham validated for ages 30–74 without prior cardiovascular disease

Sex

Lipid units

Framingham uses mg/dL internally — mmol/L values convert automatically (mg/dL = mmol/L × 38.67).

Lipid panel

Total Cholesterol (mg/dL)

Range: 130–320 mg/dL (3.4–8.3 mmol/L)

HDL Cholesterol (mg/dL)

Range: 20–100 mg/dL (0.5–2.6 mmol/L)

Blood pressure & risk factors

Systolic Blood Pressure (mmHg)

On blood pressure medication?

Current smoker?

Diabetes?

How this Framingham Risk Score calculator works

This tool returns two validated Framingham scores from one set of inputs: General CVD risk (2008 D'Agostino) — CHD, stroke, PAD, and heart failure — and Hard CHD risk (1998 Wilson) — coronary heart disease only (angina, MI, coronary death). Enter age (30–74), sex, total and HDL cholesterol, systolic blood pressure (with BP medication status), current smoking, and diabetes (used in the general CVD model only).

General CVD uses sex-specific Cox coefficients with log-transformed age, lipids, and BP (treated vs untreated), plus smoking and diabetes. Hard CHD uses the classic Wilson model with age×cholesterol and age×smoking interaction terms — the same equation used on MDCalc and in ATP III guidelines. Both use the same categories: < 10% low, 10–20% intermediate, ≥ 20% high.

Your report shows both risk percentages side by side, separate category labels for general CVD and hard CHD, non-HDL cholesterol, treatment guidance, risk factor profile, lifestyle recommendations, next steps, and PDF export. CHD risk is typically lower than general CVD because stroke, PAD, and heart failure are excluded.

This is the official Framingham risk score page — general CVD leads, hard CHD follows. For a coronary heart disease–focused experience (hard CHD first), see our Coronary Heart Disease Risk Calculator. For US statin decisions, see our ASCVD 10-Year Risk Calculator.

Pair with our Heart Age, LDL Cholesterol, Blood Pressure Risk, and Diabetes Risk calculators. Scroll below for general CVD vs hard CHD comparison, when to use which calculator, worked examples, formula details, clinical screening notes, and FAQs.

Framingham Risk Score Calculator — General CVD & Hard CHD

Millions search "Framingham risk score", "Framingham CHD calculator", and "10 year heart disease risk" each year. Our calculator returns two validated Framingham scores from one set of inputs: the 2008 D'Agostino General CVD Risk Score (coronary heart disease, stroke, peripheral artery disease, or heart failure) and the 1998 Wilson Hard CHD Risk Score (angina, myocardial infarction, or coronary death only). Both use sex-specific Cox models from the Framingham Heart Study with age, total and HDL cholesterol, systolic blood pressure, smoking, and BP medication status. Diabetes is included in the general CVD model only.

This is different from our Cardiovascular Risk Calculator, which uses a simplified educational score. For US statin decisions, see our ASCVD 10-Year Risk Calculator. Pair Framingham results with our LDL Cholesterol Calculator, Blood Pressure Risk Calculator, Heart Age Calculator, and Diabetes Risk Calculator for a complete cardiovascular prevention picture.

When to Use Framingham vs. CHD Risk Calculator

Use this Framingham Calculator if…

You want the official Framingham risk score
General CVD (stroke, PAD, heart failure) is your primary concern
You searched "Framingham calculator" or "D'Agostino CVD"
You need Framingham Heart Study context for clinical discussions

Use CHD Risk Calculator if…

You want coronary heart disease or heart attack risk
Angina, MI, or coronary death is your focus
You searched "CHD risk" or "coronary artery disease"
Hard CHD leads; general CVD is supporting context

Why Calculate Both General CVD and Hard CHD Risk?

General CVD risk (2008) captures your overall cardiovascular burden — CHD plus stroke, PAD, and heart failure. It aligns with CDC Heart Age and is ideal for understanding total cardiovascular risk. Hard CHD risk (1998 Wilson) is the classic "Framingham Risk Score" used on MDCalc and in ATP III guidelines — it estimates coronary events only and is typically lower than general CVD. Seeing both helps you and your clinician interpret results: a patient might have 10% general CVD but 6.5% hard CHD. Risk ≥ 20% on either score is high; 10–20% is intermediate.

1What You Enter

Demographics

Age — 30–74 years (Framingham validated range)
Sex — Male or Female (separate equations)

Clinical values

Total cholesterol — mg/dL or mmol/L
HDL cholesterol — mg/dL or mmol/L
Systolic BP — mmHg + medication status
Smoking — yes/no (both models)
Diabetes — yes/no (general CVD model only)

Example (Low risk — 45-year-old man)

Male, age 45, TC 213 mg/dL, HDL 50 mg/dL, SBP 120 mmHg, non-smoker, no diabetes → ~5.7% general CVD and ~2.7% hard CHD (both low). Continue lifestyle optimization and periodic screening.

Example (55-year-old man — intermediate CHD)

Male, age 55, TC 213 mg/dL, HDL 50 mg/dL, SBP 120 mmHg, non-smoker → ~10.2% general CVD, ~6.5% hard CHD. CHD risk matches classic MDCalc Framingham output.

Example (High risk — smoker with diabetes)

A 60-year-old man who smokes, has diabetes, TC 240 mg/dL, HDL 38 mg/dL, SBP 145 mmHg on medication may show ~76% general CVD and ~29% hard CHD — aggressive risk factor control typically indicated.

2Risk Categories (Both Scores)

Category	10-Year Risk	Typical Action
Low	< 10%	Lifestyle counseling; monitor risk factors
Intermediate	10% to < 20%	Intensify lifestyle; discuss statins and BP targets
High	≥ 20%	Aggressive risk reduction; pharmacotherapy typically indicated

3What You Get in Your Report

10-year general CVD risk % — 2008 D'Agostino (CHD, stroke, PAD, heart failure)
10-year hard CHD risk % — 1998 Wilson (angina, MI, coronary death)
Separate risk categories for general CVD and hard CHD — Low, Intermediate, or High each
Non-HDL cholesterol (TC − HDL) computed automatically
Treatment guidance based on risk category
Risk factor profile — impact of each input
Lifestyle recommendations, next steps, and clinical insights
PDF export & share for doctor visits

4How the Two Framingham Formulas Work

General CVD (2008 D'Agostino)

Log-transform age, TC, HDL, SBP (treated vs untreated)
Add binary smoking and diabetes terms
Risk = 1 − S₀^exp(LP − M); S₀ = 0.88936 (men), 0.95012 (women)

Hard CHD (1998 Wilson)

Log age, TC, HDL, SBP + BP medication indicator
Add age×cholesterol and age×smoking interactions
Men also include age² term; S₀ = 0.9402 (men), 0.98767 (women)
Diabetes not in Wilson CHD equation

Coefficients from D'Agostino et al. (Circulation 2008) and Wilson et al. (Circulation 1998). Verified against Framingham Heart Study and CVrisk reference implementations.

General CVD vs Hard CHD — What's the Difference?

Model	Year	Events predicted	Diabetes?	Typical use
General CVD	2008	CHD, stroke, PAD, heart failure	Yes	CDC Heart Age; total CVD burden
Hard CHD	1998	Angina, MI, coronary death only	No	MDCalc; classic Framingham score; ATP III

Framingham Risk in India & South Asia — Clinical Context

Earlier onset: South Asians develop coronary artery disease 10–15 years earlier than Western populations
Calibration limits: Framingham was derived from a predominantly White US cohort — may underestimate risk in South Asians
Diabetes epidemic: India has 100+ million adults with diabetes — affects general CVD score; manage clinically even if Wilson CHD omits diabetes
Lipid pattern: Low HDL + high triglycerides common even at normal BMI — non-HDL may be more informative than LDL alone
Screening cost: Lipid panel ₹300–800; consider ASCVD PCE alongside Framingham for US-guideline-aligned statin decisions

Limitations & When Not to Use Framingham

Not for patients with established CVD (prior MI, stroke, PAD, heart failure)
Validated ages 30–74 only — extrapolation outside this range
May not calibrate perfectly to all ethnic groups
Does not include family history, Lp(a), hs-CRP, or CAC score
For US statin decisions, ASCVD Pooled Cohort Equations are preferred per ACC/AHA guidelines
Framingham general CVD is broader than hard CHD — compare both scores on your report

Framingham vs ASCVD vs Other Risk Tools

Tool	Events predicted	Key inputs	Primary use
Framingham Hard CHD (1998)	Coronary events (angina, MI, death)	Age, sex, lipids, BP, smoking	Classic Framingham score; MDCalc
Framingham General CVD (2008)	CHD, stroke, PAD, heart failure	Age, sex, lipids, BP, smoking, diabetes	General CVD risk; CDC Heart Age
ASCVD PCE (2013)	Hard ASCVD (MI, CHD death, stroke)	Age, sex, race, lipids, BP, smoking, diabetes	US statin decisions (ACC/AHA)
QRISK (UK)	CVD events	Age, sex, ethnicity, lipids, BP, smoking, diabetes, family history	UK primary prevention
Our Cardiovascular Risk Calculator	Educational screening domains	Simplified point score	Self-screening only — not validated

Understanding Each Framingham Risk Factor

The Framingham general CVD and hard CHD models weight clinical variables differently by sex. Understanding each input helps you interpret both scores and prioritize modifiable factors—smoking cessation and blood pressure control often yield the largest risk reductions.

Age & sex

Age is the strongest driver in Framingham models—risk rises substantially after 50. Men generally have higher baseline CVD event rates at younger ages; women catch up after menopause. Framingham uses separate equations for men and women.

Validated Framingham age range: 30–74 years
Ages under 30: consider lifetime risk tools instead
Post-menopausal women: LDL often rises; HDL may fall

Total & HDL cholesterol

Total cholesterol reflects all circulating cholesterol in lipoproteins. HDL is protective—higher HDL lowers Framingham risk. Non-HDL (TC − HDL) captures LDL, VLDL, and IDL particles.

Desirable total cholesterol: < 200 mg/dL
Optimal HDL: ≥ 60 mg/dL (men ≥ 40, women ≥ 50 acceptable)
Use fasting lipids (9–12 h) for consistent trending

Systolic blood pressure

Systolic BP predicts stroke, heart failure, and coronary disease strongly in Framingham. The model uses different coefficients if you take BP medication. Target < 130/80 mmHg per ACC/AHA if tolerated.

Normal: < 120/80 mmHg
Elevated: 120–129 systolic, < 80 diastolic
Stage 1 HTN: 130–139 / 80–89 mmHg
Home BP monitoring improves accuracy vs. single clinic reading

Smoking & diabetes

Current smoking raises both general CVD and hard CHD risk. Quitting reduces risk within 1–2 years. Diabetes is included in the 2008 general CVD model but not in the 1998 Wilson hard CHD equation — diabetes still warrants aggressive clinical management.

Former smokers (> 12 months quit) usually count as non-smokers
Type 2 diabetes: target HbA1c < 7% individualized
Prediabetes: lifestyle intervention can prevent progression

Framingham Screening in India — Practical Notes

Cardiovascular disease causes roughly 28% of deaths in India, with South Asians experiencing MI 10–15 years earlier than Western cohorts. Lipid panels cost ₹300–800 at most labs. Generic statins (atorvastatin, rosuvastatin) cost ₹50–500/month.

Tips for Indian patients

Screen lipids from age 35–40 if family history of early heart disease
Low HDL + high TG pattern is common—check non-HDL, not LDL alone
Framingham may underestimate South Asian risk—discuss with cardiologist
Control diabetes aggressively—100+ million adults affected nationally
Replace ghee and palm oil with mustard, groundnut, or rice bran oil in moderation
Walk 30 min daily—low physical activity is a major modifiable risk
Bring PDF export from this calculator to your doctor visit

Frequently Asked Questions (FAQs)

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Framingham Risk Score Calculator

Demographics

Lipid panel

Blood pressure & risk factors

How this Framingham Risk Score calculator works

Framingham Risk Score Calculator — General CVD & Hard CHD

When to Use Framingham vs. CHD Risk Calculator

Use this Framingham Calculator if…

Use CHD Risk Calculator if…

Why Calculate Both General CVD and Hard CHD Risk?

1What You Enter

Demographics

Clinical values

Example (Low risk — 45-year-old man)

Example (55-year-old man — intermediate CHD)

Example (High risk — smoker with diabetes)

2Risk Categories (Both Scores)

3What You Get in Your Report

4How the Two Framingham Formulas Work

General CVD (2008 D'Agostino)

Hard CHD (1998 Wilson)

General CVD vs Hard CHD — What's the Difference?

Framingham Risk in India & South Asia — Clinical Context

Limitations & When Not to Use Framingham

Framingham vs ASCVD vs Other Risk Tools

Understanding Each Framingham Risk Factor

Age & sex

Total & HDL cholesterol

Systolic blood pressure

Smoking & diabetes

Framingham Screening in India — Practical Notes

Tips for Indian patients

Frequently Asked Questions (FAQs)

What is the Framingham Risk Score?

What is the difference between General CVD and Hard CHD risk?

How is the General CVD risk score calculated?

How is the Hard CHD risk score calculated?

Who should use the Framingham risk calculator?

What are the Framingham risk categories?

Why is my Hard CHD risk lower than my General CVD risk?

Does diabetes affect both Framingham scores?

What is the difference between Framingham and ASCVD risk calculators?

Does Framingham use race or ethnicity?

What cholesterol values should I enter?

Should I enter treated or untreated blood pressure?

Does smoking status matter?

What is the difference between Framingham and the Cardiovascular Risk Calculator on this site?

How accurate are the Framingham models?

Can I use this calculator if I am under 30 or over 74?

What events does General CVD predict vs Hard CHD?

Is Framingham still used clinically?

What lifestyle changes lower Framingham risk?

How does Framingham relate to Heart Age?

Is this calculator a substitute for medical advice?

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