FRAMINGHAM RISK SCORE (FRS) Date:

Estimation of 10-year Cardiovascular Disease (CVD) Risk Patient’s Name:

Step 11 Step 21 Step 31

In the “points” column enter the appropriate value according to the patient’s age, HDL-C, total Using the total points from Step 1, determine the Using the total points from Step 1, determine
cholesterol, systolic blood pressure, and if they smoke or have diabetes. Calculate the total points. 10-year CVD risk* (%). heart age (in years).

Risk Factor Risk Points Points Total Points 10-Year CVD Risk (%)*
Heart Age, y Men Women
Men Women
Men Women -3 or less <1 <1 <30 <0 <1
Age -2 1.1 <1 30 0
-1 1.4 1.0 31 1
30-34 0 0 0 1.6 1.2 32 1
35-39 2 2 1 1.9 1.5 34 2 2
2 2.3 1.7 36 3 3
40-44 5 4 3 2.8 2.0 38 4
45-49 7 5 4 3.3 2.4 39 4
50-54 8 7 5 3.9 2.8 40 5
6 4.7 3.3 42 6 5
55-59 10 8 7 5.6 3.9 45 7 6
60-64 11 9 8 6.7 4.5 48 8 7
9 7.9 5.3 51 9 8
65-69 12 10 10 9.4 6.3 54 10
70-74 14 11 11 11.2 7.3 55 9
12 13.3 8.6 57 11
75+ 15 12 13 15.6 10.0 59 10
HDL-C (mmol/L) 14 18.4 11.7 60 12
15 21.6 13.7 64 13 11
>1.6 -2 -2 16 25.3 15.9 68 14 12
1.3-1.6 -1 -1 17 29.4 18.51 72 15
18 >30 21.5 73 13
1.2-1.29 0 0 19 >30 24.8 76 16
0.9-1.19 1 1 20 >30 27.5 79 14
21+ >30 >30 >80 ≥17 15+
<0.9 2 2
* Double cardiovascular disease risk percentage for individuals between the ages of 30 and 59 without diabetes if the presence of a positive history
Total Cholesterol of premature cardiovascular disease is present in a first-degree relative before 55 years of age for men and before 65 years of age for women.
This is known as the modified Framingham Risk Score.3
<4.1 0 0
Step 42,3
4.1-5.19 1 1 Using 10-year CVD risk from Step 2, determine if patient is Low, Moderate or High risk.† Indicate Lipid
5.2-6.19 2 3 and/or Apo B targets
6.2-7.2 3 4 Risk Level† Initiate Treatment If: Primary Target (LDL-C) Alternate Target
>7.2 4 5 • ≤2 mmol/L or ≥50% decrease • Apo B ≤0.8 g/L or
High • Consider treatment in all
Systolic Blood Not Not FRS ≥20% (Strong, High) in LDL-C • Non-HDL-C ≤2.6 mmol/L
Pressure (mmHg) Treated Treated (Strong, Moderate) (Strong, High)
Treated Treated
<120 -2 0 -3 -1 Intermediate • LDL-C ≥3.5 mmol/L • ≤2 mmol/L or ≥50% decrease • Apo B ≤0.8 g/L or
FRS 10-19% (Strong, Moderate) in LDL-C • Non-HDL-C ≤2.6 mmol/L
120-129 0 2 0 2 • For LDL-C <3.5 mmol/L (Strong, Moderate) (Strong, Moderate)
130-139 1 3 1 3 consider if:
• Apo B ≥1.2 g/L
140-149 2 4 2 5 • OR Non-HDL-C ≥4.3 mmol/L
150-159 2 4 4 6 (Strong, Moderate)
• Men ≥50 and women ≥60 with
160+ 3 5 5 7 1 risk factor: low HDL-C, impaired
fasting glucose, high waist
Yes 4 3 circumference, smoker,
Smoker
No 0 0 hypertension
Yes statin-indicated condition Low • statins generally not indicated • statins generally not indicated • statins generally
Diabetes
No 0 0 FRS <10% not indicated

Total Points Statin-indicated • Clinical atherosclerosis*

1 Adapted from: D’Agostino RB et al.(i). General cardiovascular risk profile for use in primary care. The Framingham Heart Study. Circ 2008;117:743-53. conditions** • Abdominal aortic aneurysm
2 Adapted from: Genest J et al.(i). 2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia • Diabetes mellitus
and prevention of cardiovascular disease in the adult. Can J Cardiol. 2009;25(10):567-579. Age ≥ 40 years
3 Adapted from: Anderson T et al.(i). 2012 Update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of
15-Year duration for age ≥ 30
dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2013;29(2):151-167.
years (DM1) Microvascular
‡
apoB: apolipoprotein B stat, CVD: cardiovascular disease, FRS: Framingham Risk Score, HDL-C: high-density lipoprotein cholesterol, disease
LDL-C: low-density lipoprotein cholesterol. • Chronic kidney disease
* Statins indicated as initial therapy (age ≥ 50 years)
** Consider LDL-C < 1.8 mmol/L for subjects with acute coronary syndrome (ACS) within past 3 months eGFR <60 mL/min/1.73 m2 or
ACR > 3 mg/mmol
Provided courtesy of
Lipid targets LDL-C:_________________________ or Apo B:________________________