Heart Disease Risk Calculator
Framingham Risk Score — 10-Year Cardiovascular Disease Risk Prediction
All calculations happen entirely in your browser. We do not collect, store, or transmit any of your health data. Your results are never shared with anyone.
Framingham Heart Disease Risk Assessment
Enter your health information below to calculate your 10-year cardiovascular disease risk.
Understanding Heart Disease Risk
What Is Cardiovascular Disease?
Cardiovascular disease (CVD) is a group of disorders affecting the heart and blood vessels. It is the leading cause of death globally, responsible for approximately 17.9 million deaths each year according to the World Health Organization. Major types include:
- Coronary artery disease (CAD): Narrowing of the arteries that supply blood to the heart, leading to heart attack
- Stroke: Interruption of blood supply to the brain, either by blockage (ischemic) or bleeding (hemorrhagic)
- Heart failure: The heart cannot pump blood effectively to meet the body's needs
- Peripheral artery disease: Narrowing of blood vessels outside the heart, usually affecting the legs
- Aortic disease: Conditions affecting the main artery carrying blood from the heart
Risk Factors for Heart Disease
Risk factors are divided into modifiable (those you can change) and non-modifiable (those you cannot):
Modifiable Risk Factors
- High blood pressure (hypertension)
- High cholesterol (especially high LDL)
- Smoking and tobacco use
- Diabetes and prediabetes
- Obesity and overweight
- Physical inactivity
- Unhealthy diet
- Excessive alcohol use
- Chronic stress
Non-Modifiable Risk Factors
- Age (risk increases with age)
- Sex (men at higher risk earlier in life)
- Family history of heart disease
- Race and ethnicity
- Personal history of CVD
The Framingham Heart Study
The Framingham Heart Study began in 1948 in Framingham, Massachusetts, with 5,209 participants. Now in its third generation, it is one of the longest-running and most influential epidemiological studies in medical history. The study identified major cardiovascular risk factors including high blood pressure, high cholesterol, smoking, obesity, and diabetes — concepts that are now fundamental to modern cardiology.
The Framingham Risk Score, derived from this study, uses these identified risk factors to estimate an individual's 10-year probability of developing cardiovascular disease. The 2008 General CVD Risk Score (D'Agostino et al.) is the version used in this calculator.
Risk Factors Explained
Cholesterol
Cholesterol is a waxy substance found in your blood. Your body needs it to build cells, but too much can be harmful.
Total Cholesterol
- Desirable: Less than 200 mg/dL
- Borderline high: 200–239 mg/dL
- High: 240 mg/dL and above
HDL (Good) Cholesterol
- Low (higher risk): Less than 40 mg/dL (men), less than 50 mg/dL (women)
- Optimal (protective): 60 mg/dL and above
- Higher HDL helps remove LDL from arteries
LDL (Bad) Cholesterol: While not directly used in the Framingham formula, LDL is a critical marker. LDL deposits cholesterol in artery walls, forming plaques that narrow and harden arteries (atherosclerosis). Optimal LDL is below 100 mg/dL; below 70 mg/dL for high-risk individuals.
Blood Pressure
Blood pressure measures the force of blood pushing against artery walls. Persistently high blood pressure (hypertension) damages arteries and forces the heart to work harder.
- Normal: Less than 120/80 mmHg
- Elevated: 120–129 / less than 80 mmHg
- Stage 1 Hypertension: 130–139 / 80–89 mmHg
- Stage 2 Hypertension: 140+ / 90+ mmHg
- Hypertensive Crisis: Higher than 180/120 mmHg (seek emergency care)
Notably, the Framingham model assigns different point values depending on whether blood pressure is treated or untreated. Treated blood pressure at the same level carries higher risk because it indicates the underlying condition is more severe.
Smoking
Smoking is one of the strongest modifiable risk factors for CVD. It damages blood vessel linings, raises blood pressure, reduces HDL cholesterol, and increases blood clot formation. Smokers have 2–4 times the risk of heart disease compared to nonsmokers. Quitting smoking reduces cardiovascular risk significantly within just 1–2 years.
Diabetes
Diabetes significantly increases CVD risk. High blood sugar damages blood vessels and nerves that control the heart. Adults with diabetes are 2–4 times more likely to die from heart disease. The Framingham model assigns additional points for diabetes, reflecting this substantially elevated risk.
Age and Sex
CVD risk increases with age as arteries stiffen and plaque accumulates. Men tend to develop CVD approximately 10 years earlier than women, though women's risk rises sharply after menopause. By age 70–79, the risk difference between sexes narrows considerably.
Reducing Your Risk
Heart-Healthy Diet
Two evidence-based dietary patterns have the strongest support for cardiovascular health:
Mediterranean Diet
- Abundant fruits, vegetables, whole grains, legumes
- Olive oil as primary fat source
- Fish and poultry over red meat
- Moderate red wine (optional)
- Nuts and seeds daily
- Reduces CVD risk by up to 30% (PREDIMED trial)
DASH Diet
- Rich in fruits, vegetables, whole grains
- Low-fat dairy products
- Lean meats, fish, poultry
- Limited sodium (1,500–2,300 mg/day)
- Reduces saturated fat and added sugars
- Can lower systolic BP by 8–14 mmHg
Exercise
The AHA recommends at least 150 minutes per week of moderate-intensity aerobic activity (such as brisk walking, cycling, or swimming) or 75 minutes per week of vigorous-intensity activity. Additional benefits come from muscle-strengthening activities at least 2 days per week. Regular exercise:
- Lowers blood pressure by 5–8 mmHg
- Raises HDL cholesterol
- Helps manage weight and blood sugar
- Reduces stress and inflammation
- Strengthens the heart muscle
Quit Smoking
Quitting smoking is the single most impactful step a smoker can take for heart health. Within 1 year of quitting, heart disease risk drops to about half that of a current smoker. Within 5–15 years, stroke risk equals that of a nonsmoker. Resources include:
- 1-800-QUIT-NOW: Free coaching, available 24/7
- Nicotine replacement therapy: Patches, gum, lozenges (over the counter)
- Prescription medications: Varenicline (Chantix), bupropion (Zyban)
- smokefree.gov: Online tools, apps, and text programs
Medication Adherence
If prescribed medications for blood pressure, cholesterol, or diabetes, taking them consistently as directed is critical. Studies show that non-adherence to statins increases heart attack risk by 25%, and non-adherence to blood pressure medications increases stroke risk by 30–40%. Talk with your doctor before stopping or changing any medication.
Stress Management
Chronic stress contributes to heart disease through elevated blood pressure, inflammation, and unhealthy coping behaviors. Evidence-based stress reduction techniques include:
- Mindfulness meditation (even 10 minutes daily has measurable benefits)
- Regular physical activity
- Adequate sleep (7–9 hours per night)
- Social connection and support
- Cognitive behavioral therapy (CBT) for chronic stress
Cholesterol & Blood Pressure
Target Numbers
Cholesterol Targets
- Total cholesterol: Below 200 mg/dL
- LDL cholesterol: Below 100 mg/dL (below 70 if high-risk)
- HDL cholesterol: Above 40 mg/dL (men), above 50 mg/dL (women)
- Triglycerides: Below 150 mg/dL
Blood Pressure Targets
- General population: Below 130/80 mmHg (2017 ACC/AHA)
- High-risk patients: Below 130/80 mmHg
- Older adults (65+): Individualized, often below 130 systolic
- Diabetics: Below 130/80 mmHg
When to Get Tested
- Cholesterol: Adults 20+ should be screened every 4–6 years; annually if elevated or on treatment
- Blood pressure: At every healthcare visit; at least once per year for adults
- Blood glucose: Every 3 years starting at age 45, or earlier if risk factors are present
- Earlier screening is recommended if you have a family history of heart disease, diabetes, or if you smoke
Treatment Options
For High Cholesterol:
- Statins: First-line treatment; can reduce LDL by 30–50% (e.g., atorvastatin, rosuvastatin)
- Ezetimibe: Reduces cholesterol absorption; often added to statins
- PCSK9 inhibitors: Injectable medications for very high LDL or statin intolerance
- Bile acid sequestrants: Older class, sometimes used as add-on therapy
For High Blood Pressure:
- ACE inhibitors / ARBs: Relax blood vessels (e.g., lisinopril, losartan)
- Calcium channel blockers: Relax arterial walls (e.g., amlodipine)
- Thiazide diuretics: Reduce fluid volume (e.g., hydrochlorothiazide)
- Beta-blockers: Slow heart rate and reduce force of contraction
- Many patients require 2–3 medications to reach target blood pressure
Lifestyle vs. Medication
Lifestyle changes are the foundation of treatment for both high cholesterol and high blood pressure. For many people with mild elevations, diet, exercise, weight loss, and smoking cessation may be sufficient. However, medication is typically needed when:
- Levels remain elevated despite lifestyle changes
- 10-year CVD risk is 10% or higher
- LDL is 190 mg/dL or above (regardless of risk)
- You have diabetes with LDL 70–189 mg/dL
- Blood pressure is consistently 140/90 or higher despite lifestyle efforts
Lifestyle changes enhance the effectiveness of medications and may allow lower doses. Never stop taking prescribed medication without consulting your doctor.
Frequently Asked Questions
The Framingham Risk Score is a validated clinical tool that estimates your 10-year risk of developing cardiovascular disease (including heart attack, stroke, and heart failure). It was developed from data collected in the Framingham Heart Study, which has followed thousands of participants since 1948. The score considers your age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure treatment status, smoking status, and diabetes status. The version used here is the 2008 General CVD Risk Score published by D'Agostino et al. in the journal Circulation.
Low risk (less than 10%): Your 10-year probability of a cardiovascular event is relatively low. Continue maintaining healthy habits. Moderate risk (10–20%): You have an intermediate risk and may benefit from lifestyle modifications and possibly medication, depending on other factors. High risk (greater than 20%): Your 10-year probability is elevated, and more aggressive prevention strategies including medication therapy are typically recommended. These thresholds are widely used by the American Heart Association and the American College of Cardiology to guide treatment decisions.
The Framingham Risk Score has been extensively validated across multiple populations and is one of the most widely used cardiovascular risk prediction tools worldwide. However, it has some limitations: it was originally developed in a predominantly White population, so it may overestimate risk in some groups (e.g., Japanese Americans, Hispanic Americans) and underestimate risk in others (e.g., South Asian Americans). It also does not account for all risk factors such as family history, obesity, inflammatory markers, or coronary artery calcium scores. Your healthcare provider may use additional tools and clinical judgment to refine your risk assessment.
Yes. Several factors in the Framingham score are modifiable. You can lower your score by reducing total cholesterol (through diet, exercise, and/or statins), raising HDL cholesterol (through exercise and healthy fats), lowering blood pressure (through diet, exercise, weight loss, and/or medication), quitting smoking, and managing diabetes effectively. Even modest improvements in these factors can meaningfully reduce your 10-year risk. For example, quitting smoking alone removes 3 points from the score, and improving cholesterol levels can reduce points as well.
In the Framingham model, being on blood pressure medication at a given systolic level indicates that your underlying (untreated) blood pressure would be even higher. The medication is bringing your reading down, but the fact that treatment is needed reflects a more severe underlying condition. Additionally, the residual risk from longstanding hypertension may not be fully eliminated by treatment. This is why the same blood pressure reading carries more risk points when treated than when naturally occurring at that level.
Yes. Sharing your estimated Framingham Risk Score with your healthcare provider can be a valuable starting point for discussion about your cardiovascular health. Your doctor can verify the inputs, consider additional risk factors not captured by the score (such as family history, inflammatory markers, and coronary artery calcium), and develop a personalized prevention plan. This calculator provides an estimate for educational purposes, but clinical decisions should always be made in partnership with a qualified healthcare professional.
Medical Disclaimer
This Framingham Heart Disease Risk Calculator is provided for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
- The Framingham Risk Score is a screening tool, not a diagnostic instrument.
- Only a qualified healthcare provider can fully assess your cardiovascular risk.
- Always consult your doctor before starting, stopping, or changing any treatment.
- If you are experiencing chest pain, shortness of breath, or other cardiac symptoms, call 911 or seek emergency care immediately.
Privacy: All calculations happen in your browser. We do not store, transmit, or share your health data.
References & Sources
- D'Agostino RB Sr, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117(6):743-753. PubMed
- Framingham Heart Study. A Project of the National Heart, Lung, and Blood Institute and Boston University. framinghamheartstudy.org
- Arnett DK, Blumenthal RS, Fonarow GC, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Circulation. 2019;140(11):e596-e646. PubMed
- Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837-1847. PubMed
Last Updated: February 2026