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Jan 31, 2024

Heart Health

Framingham Risk Score

What Is High Cholesterol?

Cholesterol is an essential component of blood in our body. We make cholesterol in our livers, but we also get additional cholesterol from our diet. There are “good” cholesterols such as HDL, which take fats from your body and bring it to your liver to be recycled. There are also “bad” cholesterols, such as VLDL and LDL which carry fats to the various parts of your body. Sometimes we can get too much of the “bad” cholesterols and the fats they carry around your body will begin to build up in your blood vessels.

When LDL levels get too high, and/or the level of HDL gets too low, you may be considered to have “high cholesterol”. The main treatment strategy for individuals with high cholesterol is to initiate statin therapy. Statins are medications that work to decrease the amount of cholesterol made by the liver.

What is cholesterol and why you should care

Link between High Cholesterol and Heart Disease

High cholesterol levels are strongly linked to the development of heart diseases. This is because excessive fats circulating in the blood eventually begin to stick to your blood vessels and form dangerous plaques.

As this builds up, the space in which blood can flow becomes narrowed, increasing the pressure and making it more difficult for blood to move. More dangerously, sometimes these plaques can break off and end up in another blood vessel, ultimately blocking off blood flow completely to that part of the body. This could potentially cause a dangerous event such as a heart attack or stroke.

This is why it is essential to monitor cholesterol levels and take quick action when levels are too high, in order to prevent this build up from occurring and minimize your risk of developing heart disease.

What is the Framingham Risk Calculator?

The Framingham Risk Calculator, also known as the Framingham Risk Score, is a widely used tool for estimating an your risk of developing cardiovascular disease (CVD), specifically coronary heart disease (CHD) or stroke, over a certain period of time, usually 10 years. It is named after the town of Framingham, Massachusetts, where the Framingham Heart Study was conducted.

The calculator uses a set of risk factors such as total cholesterol levels, HDL levels, systolic, and blood pressures. These factors have been identified as significant predictors of CVD based on extensive research conducted as part of the Framingham Heart Study.

Healthcare providers will begin to assess your risk of developing heart disease once you reach a certain age (typically 40 years old), or if you already have below risk factors.

  • Diabetes
  • History of high blood pressure during pregnancy
  • Chronic kidney disease
  • Obesity
  • Smoking
  • Family history of high blood pressure and/or high cholesterol

If you meet any of these criteria, your healthcare provider will likely complete a calculation of your risk for heart disease. The Framingham risk calculator is a tool that healthcare providers use in order to assess your individual risk of developing heart disease. They do this using your demographics as well as cholesterol levels calculated from blood tests.

This score will then help guide your healthcare provider in the treatment strategy best for your personal prevention of heart disease.

Factors Involved in the Calculation

Before the calculation can be performed, your healthcare provider will likely require you to get blood tests. With these results, as well as your medical history, your healthcare provider will complete your calculation. The calculation itself is divided into three sections: patient demographics, lab values, and medical history.

Patient demographics

  • Sex
  • Age

Patient lab values

  • HDL-cholesterol
  • Total cholesterol
  • Systolic blood pressure

Patient history

  • History of diabetes
  • Smoking historyAge

Each of these factors has a series of points attached, depending on if the answer is a yes or no, as well as where you fall in each of the scales (such as higher or lower lab values). In the end, you will end up with anywhere from less than -3 to more than +21.

Calculate Your Score

In the below calculator enter your gender, age, cholesterol level, BP and you get the 'Framingham Risk Score' and the risk of developing CHD. Higher the score, higher is the percentage of developing CHD.

Note: This statistics calculator is presented for your own personal use and is to be used as a guide only. Medical and other decisions should NOT be based on the results of this calculator. Although this calculator has been tested, we cannot guarantee the accuracy of its calculations or results.

What Does My Score Mean?

The more patient-friendly use of this score is to determine your heart health. The number of points you end up with corresponds with a “heart age”. In general, the higher your score, the “older” your heart is. This is a great way to symbolize how your real age relates to the health of your heart. If your heart’s “age” is older than your real age, this is a bad sign.

Most importantly for your healthcare provider, your score will also sort you into one of three groups

  • Low risk (<10%)
  • Intermediate risk (10-19%)
  • High risk (≧20%)

The percentage is considered to be an estimation of the percent risk you have of developing heart disease in the next 10 years. Additionally, the group you have been sorted into will help guide treatment in order to reduce your risk. The higher your score, the more intense the treatment is likely to be.

How Can I Decrease My Score?

Based on your individual score, your healthcare provider will provide you with treatment strategies to help reduce your risk of heart disease.

Regardless of your category, lifestyle changes are always recommended. In general, low risk individuals are only recommended lifestyle changes to lower and/or maintain their low score. High risk individuals are immediately recommended statin initiation. Intermediate risk individuals are slightly more complicated. If you fall into an intermediate risk category, your healthcare provider will then take more factors into account to determine statin initiation, including any of the following:

  • LDL levels >3.5mmol/L
  • LDL levels <3.5 but Apo B >1.2g/L or non-HDL >4.3 mmol/L
  • Men >50 years old or women >60 years old with any of: high blood sugar, high waist circumference (obesity), smoker, and/or high blood pressure.

In addition, the Framingham risk calculator also lists conditions in which statins are automatically recommended. This includes:

  • Atherosclerosis
  • Abdominal aortic aneurism
  • Diabetes and <40 years old
  • Chronic kidney disease eGFR <60mL/min

Compare Statins

Getting Involved in Your Care

Many healthcare providers will calculate your risk score at a general health appointment once you reach a certain age. However, you can also take this into your own hands, and ask your provider to complete an assessment if they haven’t already. In addition, there are also some online calculators that you can do yourself to get a beginning idea of your own risk. However, in most cases it is still important to speak with a healthcare provider about this risk in order to best understand and manage your possibility of developing heart disease.


  1. Calculators and forms. Canadian Cardiovascular Society. (2021, April 29). Retrieved May 3, 2023, from
  2. Pearson, G. J., Thanassoulis, G., Anderson, T. J., Barry, A. R., Couture, P., Dayan, N., Francis, G. A., Genest, J., Grégoire, J., Grover, S. A., Gupta, M., Hegele, R. A., Lau, D., Leiter, L. A., Leung, A. A., Lonn, E., Mancini, G. B. J., Manjoo, P., McPherson, R., … Wray, W. (2021). 2021 Canadian Cardiovascular Society Guidelines for the management of Dyslipidemia for the prevention of cardiovascular disease in adults. Canadian Journal of Cardiology, 37(8), 1129–1150.

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