# Cardiovascular Risk Calculator

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PatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.

This risk calculator uses the Framingham risk equation[1] and the adjustments as suggested by the Joint British Societies' (JBS2) paper[2] and the JBS Cardiovascular Risk Assessor.[3]

It is not the only risk calculator in use. In 2010 the National Institute for Health and Clinical Excellence (NICE) decided it could no longer recommend that the Framingham risk equation be used, as it tends to over-estimate risk by approximately 5% in UK men.[4]  The decision also coincides with the emergence of the QRISK® calculator which has been shown to predict risk more accurately. The QRISK® calculator is available at http://www.qrisk.org. For further information on QRISK® see our cardiovascular risk assessment article.

Cardiovascular Risk Calculator For Primary Prevention
This calculator should not be used if patient has known CVD or diabetes (already known to be at high risk)
Age (30-74)Smoking Status
SexGlucose
Systolic BPLVH
Diastolic BPCentral Obesity
Total CholesterolSouth Asian Origin
HDL CholesterolFamily History of CVD
(Men
Total /HDL Ratio
Serum TG mmol/L
Using Systolic BP prediction, the 10-year risk ofis %
The equivalent risk calculation with diastolic BP is %

The following patients will have higher risks:

• Significant family history (men <55 and women <65 years with one first-degree relative), impaired fasting glucose and South Asian origin increase the risk by a factor of 1.5. If more than one first-degree relative is affected, the risk may be increased by a factor of up to 2.[5][6]
• Obesity (BMI=30 kg/m2), especially central obesity in men with waists =102 cm in Caucasians (=90 cm in Asians). Corresponding waist values for women are =88 cm and =80 cm. Obesity increases risk by a factor of 1.3.
• Serum triglyceride of 1.7 mmol/L or more increases CVD risk by 1.3 times (this calculator treats it the same as obesity). A low HDL cholesterol (<1.0 mmol/L in men and <1.2 mmol/L in women) also increases risk.
• Although raised serum triglyceride increases risk, including triglyceride in a multivariate equation will reduce the variation in risk explained by the other risk factors. Successively multiplying risk for factors not included in the original equations of Anderson and colleagues will thus lead to gross overestimations of risk. On the other hand, the clinician should be aware in making clinical decisions that combinations of risk factors such as family history, high triglyceride, South Asian origin, and impaired fasting glucose are likely to increase risk above that shown by the programme.
• If any combination of impaired fasting glucose, South Asian origin, adverse family history or raised serum triglyceride occurs, risk is only increased by whichever of these factors in the combination gives the highest risk. In this calculator, none of them increases the risk further when left ventricular hypertrophy (LVH) is present - as LVH increases risk so much that further multiplying risk to take into account other factors is likely to be inaccurate.