The Framingham Heart Study – 10 Year Risk Assessment
The Framingham Heart Study is an epidemiologic study begun in 1948 with 5,209 men and women. Since that time the study has studied three generations of participants resulting in biological specimens and data from nearly 15,000 participants. This clinically and genetically well characterized population is a valuable scientific source that is maintained under the stewardship of Boston University and the NHBLI.
Over the years of monitoring, the Framingham Heart Study identified the major cardiovascular disease risk factors – high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity, as well as the effects of other factors like gender, age, genetics and blood triglycerides.
The Framingham Risk Assessment tool was developed by Boston University. It uses recent data from the Framingham Heart Study to estimate 10-year risk for "hard" coronary heart disease outcomes (myocardial infarction and coronary death) in adults who do not have heart disease or diabetes. The risk factors included in the Framingham calculation are age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for hypertension, and cigarette smoking. Because of a larger database, Framingham estimates are more robust for total cholesterol than for LDL cholesterol. Note, however, that LDL cholesterol remains the primary target of therapy.
Calculate your Framingham Risk Score
The Reynolds Risk Score
For about 10 years, the Framingham risk score has been used to estimate a person’s chances of having a heart attack based on just six pieces of information — age, sex, total cholesterol, HDL cholesterol, smoking status, and systolic blood pressure. Doctors know what to recommend for people whose scores indicate high or low risk. But it’s less clear what to do with those in the middle.
Over the years, researchers have experimented with adding additional risk factors to the formula to try to narrow the grey zone of mid-range results. Now, after testing three dozen separate risk factors, Harvard researchers have found that adding just two — a measurement of C-reactive protein (hsCRP) and whether a parent had a heart attack before age 60—to the Framingham model made the resulting predictions even more accurate.
The Reynolds Risk Score was derived from information collected from more than 24,000 women for more than a decade. When used on the study group, the Reynolds risk score did as well as the Framingham risk score for women at high and low risk. For those in between, the Reynolds risk score was better. The new model reclassified almost half of these women into high-risk and low-risk groups. The new assignments, done by computer, corresponded almost perfectly to what actually happened to these women over the next 10 years. An advantage of the Reynolds model, given the excess of cerebrovascular versus coronary events in women, is that the outcome included stroke. The Reynolds model also includes hsCRP and family history of premature cardiovascular disease, both independent risk predictors in women.
Calculate your Reynolds Risk Score