Framingham Risk Score for Hard Coronary Heart Disease

id

38

full_title

Framingham Risk Score for Hard Coronary Heart Disease

short_title

Framingham Risk Score (Hard Coronary Heart Disease)

med_description

Estimates 10-year risk of heart attack in patients 30-79 years with no history of CHD or diabetes.

description

The Framingham Coronary Heart Disease Risk Score estimates risk of heart attack in 10 years.

keywords

Framingham Coronary Heart Disease Risk Score, framingham, framingham score, framingham cardiac, framingham coronary, framingham calc, framingham CHD, framingham heart disease, framingham risk, CHD risk, chd risk score, chd risk calc, chd calc, chd score, CAD score, CAD framingham, framingham hld, framingham cholesterol, fram heart, fram cvd, framingham cvd, framingham calc, framingham score, framingham risk, fram risk cvd, fram CAD risk, fram CVD risk, framingham chd calc, 10 year chd risk, 10 year cad risk, 10 year cvd risk, 10 yr chd risk, 10 yr cad risk, 10 yr cvd risk, 10 year risk of MI, long term MI risk, longitudinal MI risk, longitudinal heart attack risk, long term heart attack risk, long term mi, long term heart attack, framingham cholesterol, framingham hld, cad risk factor man, chd risk factor man, cad risk factor male, chd risk factor male, cad risk factor female, chd risk factor female, cad risk factor woman, chd risk factor woman, heart attack risk smoker, heart attack risk smoke, heart attack risk tobacco use

complaint

[ "Chest Pain", "Palpitations", "Shortness of Breath" ]

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)

*Yes = 1, No = 0.

**Men: if age >70, use ln(70) × Smoker. Women: if age >78, use ln(78) × Smoker.

evidence

measurements

[ { "name": "Total Cholesterol", "unit": "chol_total", "error_min": "40", "error_max": "1000", "warn_min": "150", "warn_max": "500", "conversion": "0.02586", "normal_max_si": "5.2", "normal_max_us": "200", "normal_min_si": "3.9", "normal_min_us": "150", "units_si": "mmol/L", "units_us": "mg/dL" }, { "name": "Systolic BP", "unit": "sbp", "error_min": "30", "error_max": "300", "warn_min": "40", "warn_max": "250", "conversion": "1", "normal_max_si": "120", "normal_max_us": "120", "normal_min_si": "100", "normal_min_us": "100", "units_si": "mm Hg", "units_us": "mm Hg" }, { "name": "Age", "unit": "age", "error_min": "0.001", "error_max": "120", "warn_min": "0.1", "warn_max": "100", "conversion": "1", "normal_max_si": "0", "normal_max_us": "0", "normal_min_si": "0", "normal_min_us": "0", "units_si": "years", "units_us": "years" }, { "name": "HDL Cholesterol", "unit": "chol_hdl", "error_min": "1", "error_max": "155", "warn_min": "1", "warn_max": "95", "conversion": "0.02586", "normal_max_si": "4.01", "normal_max_us": "155", "normal_min_si": "1.55", "normal_min_us": "60", "units_si": "mmol/L", "units_us": "mg/dL" } ]

information

Interpretation:

*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.

refrences

{ "Clinical Practice Guidelines": [], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=9603539&dopt=citation", "text": "Wilson PW, et. al. Prediction of Coronary Heart Disease Using Risk Factor Categories. Circulation 1998. 97(18): 1837-1847." } ], "Other References": [ { "href": "https://www.nejm.org/doi/full/10.1056/NEJM199006073222304", "text": "Sytkowski PA, Kannel WB, D'agostino RB. Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Heart Study. N Engl J Med. 1990;322(23):1635-41. " }, { "href": "https://jamanetwork.com/journals/jama/article-abstract/367563 ", "text": "Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent Risk Factors for Atrial Fibrillation in a Population-Based Cohort. The Framingham Heart Study. JAMA. 1994;271(11):840–844. doi:10.1001/jama.1994.03510350050036" } ], "Outcomes": [], "Validation": [], "Validations": [] }

pearls

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.

usecase

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

reasons

next_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.

next_actions

next_management

diseases

[ "Acute Coronary Syndrome", "Congestive Heart Failure", "Coronary Artery Disease", "Dyslipidemia", "Myocardial Infarction" ]

instructions

There are several distinct Framingham risk models. MDCalc uses the 'Hard' coronary Framingham outcomes model, which is intended for use in non-diabetic patients age 30-79 years with no prior history of coronary heart disease or intermittent claudication, as it is the most widely applicable to patients without previous cardiac events. See the official Framingham website for additional Framingham risk models.

published

2022-04-21T20:29:19.283Z

purpose

[ "Prognosis" ]

search_terms

[ "framingham risk score", "ACS", "cardiac risk", "CHD", "CAD", "framingham", "coronary heart disease", "MI", "myocardial infarction risk" ]

seo

{ "keywords_en": "Framingham Coronary Heart Disease Risk Score, framingham, framingham score, framingham cardiac, framingham coronary, framingham calc, framingham CHD, framingham heart disease, framingham risk, CHD risk, chd risk score, chd risk calc, chd calc, chd score, CAD score, CAD framingham, framingham hld, framingham cholesterol, fram heart, fram cvd, framingham cvd, framingham calc, framingham score, framingham risk, fram risk cvd, fram CAD risk, fram CVD risk, framingham chd calc, 10 year chd risk, 10 year cad risk, 10 year cvd risk, 10 yr chd risk, 10 yr cad risk, 10 yr cvd risk, 10 year risk of MI, long term MI risk, longitudinal MI risk, longitudinal heart attack risk, long term heart attack risk, long term mi, long term heart attack, framingham cholesterol, framingham hld, cad risk factor man, chd risk factor man, cad risk factor male, chd risk factor male, cad risk factor female, chd risk factor female, cad risk factor woman, chd risk factor woman, heart attack risk smoker, heart attack risk smoke, heart attack risk tobacco use", "meta_description_en": "The Framingham Coronary Heart Disease Risk Score estimates risk of heart attack in 10 years." }

specialty

[ "Cardiology", "Critical Care", "Emergency Medicine", "Endocrinology", "Family Practice", "Geriatrics", "Hospitalist Medicine", "Internal Medicine", "Primary Care" ]

departments

[ "Cardiac" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10510, "short_title_en": "SCORE2-Diabetes", "slug": "score2-diabetes" }, { "calcId": 10499, "short_title_en": "SCORE2", "slug": "systematic-coronary-risk-evaluation-score2" }, { "calcId": 10503, "short_title_en": "SCORE2-OP", "slug": "score2-older-persons-score2-op" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "cardiology" ]

cleaned_use

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

pub

true