Coronary Heart Disease Risk Calculator

The Framingham Heart Study, running since 1948, produced the most widely used cardiovascular risk model in clinical practice. The ATP III point score condenses that research into a practical 10-year risk estimate from six inputs: age, sex, total cholesterol, HDL cholesterol, systolic blood pressure with its treatment status, and smoking.

Each factor earns points on a sex-specific scale. Age dominates, with risk rising steeply each decade. Total cholesterol counts for more in younger patients and its weight fades after 60. HDL is protective, so a high HDL scores negative points and pulls the total down. Blood pressure points are higher if you are on treatment, because treated hypertension still carries residual risk. Smoking adds heavily under 60 and much less after.

Diabetes is handled differently, and this trips up most online versions of this score. ATP III does not give diabetes points. It classes diabetes as a coronary heart disease risk equivalent: a person with diabetes is managed as though they had already had a cardiac event, whatever the point total says. The earlier 1998 Framingham model did award points for it, which is why you will find calculators that quietly add two or four. This page follows ATP III and reports the risk-equivalent category instead.

Point totals map to a 10-year risk percentage. Under 10% is low risk, 10 to 20% is intermediate, and above 20% is high risk, the level at which aggressive lipid-lowering is typically recommended regardless of what LDL alone looks like.

The model applies to ages 30 to 79 in people without existing coronary heart disease. Outside that range this page will tell you so rather than answering, because the score was never fitted there.

It is also no longer the current standard. US guidelines moved to the 2013 ACC/AHA Pooled Cohort Equations, and Europe uses SCORE2. Both will give a different number for the same person, and both were fitted on broader populations than the predominantly white American cohorts behind Framingham. It remains useful as a screening estimate and as the score most doctors can read at a glance.

A physician will fold in things no table captures: family history, inflammatory markers, coronary calcium scoring. Knowing your rough 10-year risk is still one of the more useful numbers a middle-aged adult can carry around.

Disclaimer: For educational use only. Consult a physician for medical advice.