Framingham Risk Score for Hard Coronary Heart Disease

Framingham Risk Score for Hard Coronary Heart Disease
Sex
Age
Total Cholesterol (mg/dL)
HDL (mg/dL)
Systolic Blood Pressure (mmHg)
Blood Pressure Treatment
Smoker
Framingham Score: 0
–
–
Estimates 10-year risk of heart attack in patients 30-79 years with no history of CHD or diabetes.

When to Use

Patients aged 30-79 years with no prior history of coronary heart disease. Do not use in patients with intermittent claudication or diabetes.

Formula

Equations as follows (β coefficients listed in table below): Men: L Men = β × ln(Age) + β × ln(Total cholesterol) + β × ln(HDL cholesterol) + β × ln(Systolic BP) + β × Treated for blood pressure + β × Smoker + β × ln(Age) × ln(Total cholesterol) + β × ln(Age) × Smoker + β × ln(Age) × ln(Age) - 172.300168 P Men = 1 - 0.9402 exp(LMen) Women: L Women = β × ln(Age) + β × ln(Total cholesterol) + β × ln(HDL cholesterol) + β × ln(Systolic BP) + β × Treated for blood pressure + β × Smoker + β × ln(Age) × ln(Total cholesterol) + β × ln(Age) × Smoker - 146.5933061 P Women = 1 - 0.98767 exp(LWomen) Variable Coefficient (β) Men Women ln(Age) 52.00961 31.764001 ln(Total cholesterol) 20.014077 22.465206 ln(HDL cholesterol) -0.905964 -1.187731 ln(Systolic BP) 1.305784 2.552905 Treated for blood pressure* 0.241549 0.420251 Smoker* 12.096316 13.07543 ln(Age) × ln(Total cholesterol) -4.605038 -5.060998 ln(Age) × Smoker** -2.84367 -2.996945 ln(Age) × ln(Age) -2.93323 - *Yes = 1, No = 0. **Men: if age >70, use ln(70) × Smoker. Women: if age >78, use ln(78) × Smoker.

Pearls / Pitfalls

The Framingham data, while thorough, come from many years ago with a potentially different US population along with a different diet and level of smoking as well, which may suggest different risk levels today.

Advice

Patients with high risk scores should be counseled aggressively about social factors contributing to their risk (smoking, exercise, weight, diet, etc.) and also managed with blood pressure and lipid evaluation.

More Information

Interpretation: Age, years Average 10 year hard* CHD risk in this patient Low** 10 year CHD risk in the average patient Women Men Women Men 30-34 <1% 1% <1% 2% 35-39 <1% 4% 1% 3% 40-44 1% 4% 2% 4% 45-49 2% 8% 3% 4% 50-54 3% 10% 5% 6% 55-59 7% 13% 7% 7% 60-64 8% 20% 8% 9% 65-69 8% 22% 8% 11% 70-74 11% 25% 8% 14% 74-79 Data not available Data not available Data not available Data not available *Excluding angina pectoris. **Low risk was calculated for a person the same age, optimal blood pressure, LDL-C 100-129 mg/dL or cholesterol 160-199 mg/dL, HDL-C 45 mg/dL for men or 55 mg/dL for women, non-smoker, no diabetes.

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