QRISK3 cardiovascular risk calculator

QRISK3 is a validated cardiovascular risk prediction tool used to estimate a patient’s 10-year risk of developing cardiovascular disease. It is widely used in UK primary care to support decisions about risk reduction, including lifestyle advice and statin therapy.

The calculator builds on earlier QRISK models by incorporating a broader range of clinical and demographic risk factors, improving risk estimation for groups previously under-represented.

Clinical context and use

QRISK3 is used in adults aged 25–84 years who do not already have established cardiovascular disease.

It estimates the risk of a first cardiovascular event, including myocardial infarction, angina, stroke, or transient ischaemic attack, over the next 10 years.

The score is commonly used during NHS health checks and routine cardiovascular risk assessment in general practice.

The output supports shared decision-making around prevention strategies and should be recalculated periodically as risk factors change.

QRISK3 incorporates traditional cardiovascular risk factors alongside additional clinical variables. These include:

• Age.

• Sex.

• Ethnicity.

• Smoking status.

• Blood pressure.

• Cholesterol ratio.

• Body mass index.

• Family history of premature cardiovascular disease.

It also includes conditions and factors not present in earlier models, such as:

• Chronic kidney disease.

• Atrial fibrillation.

• Migraine.

• Corticosteroid use.

• ,Severe mental illness.

• Atypical antipsychotic use.

• Erectile dysfunction.

• Systemic inflammatory conditions.

By accounting for these factors, QRISK3 provides a more personalised estimate of cardiovascular risk.

The result is expressed as a percentage, representing the estimated chance of experiencing a cardiovascular event in the next 10 years.

In UK practice, a 10-year risk of 10 percent or higher is commonly used as a threshold for considering statin therapy, alongside lifestyle modification and individual patient preference.

Risk should always be interpreted in context, taking into account patient values, comorbidities, and potential benefits and harms of treatment.

QRISK3 supports a preventive approach to cardiovascular disease by identifying patients who may benefit from early intervention.

It helps guide discussions about smoking cessation, diet, physical activity, weight management, and blood pressure control. Where appropriate, it also informs decisions about lipid-lowering therapy.

The calculator does not mandate treatment but provides an evidence-based estimate to support informed discussion.

QRISK3 was developed using large UK primary care datasets and has been externally validated in diverse populations.

It has demonstrated improved calibration and discrimination compared with earlier QRISK models, particularly in groups with conditions associated with elevated cardiovascular risk.

QRISK3 is referenced in NICE guidance for cardiovascular disease risk assessment and lipid modification.

QRISK3 estimates population-level risk and cannot predict individual outcomes with certainty.

It may underestimate or overestimate risk in some individuals, particularly those at the extremes of age or with uncommon risk profiles. It is not intended for use in patients with established cardiovascular disease, where secondary prevention guidance applies.

Clinical judgement remains essential, especially where calculated risk is close to treatment thresholds.

Using QRISK3 provides a structured way to discuss cardiovascular risk and prevention. Visualising risk can help patients understand the potential benefits of lifestyle change or medication.

Recording the score supports documentation, audit, and continuity of care. Risk should be reviewed periodically, particularly if there are changes in health status or treatment.