Framingham vs. ACC/AHA Pooled Cohort Equations?

PCE (Goff 2014) extended Framingham to include race and a wider 40-79 age band; specifically targets hard ASCVD (MI, stroke). Framingham 2008 includes broader CVD (HF, PAD too).

Why log-transform variables?

Hazard ratios scale multiplicatively with continuous risk factors — log makes the linear predictor additive on the natural scale.

Risk bands for treatment decisions?

<5% low, 5-9% borderline, 10-19% intermediate, ≥20% high. ACC/AHA 2018 cholesterol guideline (Grundy, Circulation 2018) uses ASCVD risk; statin recommended at ≥7.5% (intermediate).

Is this medical advice?

No. Educational. CVD prevention requires individual context + shared decision.

Framingham 10-Year CVD Risk Calculator

10-year general cardiovascular disease risk per D'Agostino 2008 Circulation. Sex-specific, lab-based.

Result

10-year CVD risk

8.4%

Borderline (5-9%). Male, age 50, TC 200, HDL 50, SBP 130, non-smoker, non-diabetic.

SexMale
Age50
Total cholesterol200 mg/dL
HDL50 mg/dL
SBP (untreated)130 mmHg
Current smokerNo
DiabetesNo
Linear predictor L23.6897
Mean L23.9802
S₀(10)0.88936
10-year CVD risk8.40%
Risk bandBorderline (5-9%)

Step-by-step

L = β·age + β·ln(TC) + β·ln(HDL) + β·ln(SBP) + β·smoker + β·diabetes (sex-specific β).
L = 23.6897; mean L = 23.9802.
Risk = 1 − S₀(10)^exp(L − mean) = 1 − 0.88936^exp(-0.2905) = 0.0840 = 8.40%.

How to use this calculator

Enter sex, age, TC, HDL, SBP, BP-Tx, smoker, diabetes.
Read 10-year general CVD risk + band.
Pair with risk-enhancers (FH, hsCRP, CAC, CKD, etc.).

About this calculator

Framingham general CVD risk: 10-year probability of any first CVD event (CHD, stroke, PAD, HF) in adults 30-74 without prior CVD. Source: D'Agostino RB Sr et al., "General cardiovascular risk profile for use in primary care: the Framingham Heart Study." Circulation 2008;117(6):743-53. Cox proportional hazards model, sex-specific coefficients, with treated vs. untreated SBP coefficients separately. NCEP ATP III and ACC/AHA later adopted this for primary prevention decisions. Note: ACC/AHA 2013 introduced "Pooled Cohort Equations" for ASCVD (Goff DC, Circulation 2014;129:S49) — different, more inclusive, 40-79 age range, includes race. This calc is the classic Framingham 2008 model. **Not medical advice — pair with shared decision and risk-enhancing factors.**