The Framingham Risk Score for Hard Coronary Heart Disease is a validated clinical tool that estimates a patient’s 10-year probability of experiencing a major coronary event, such as myocardial infarction or death due to coronary heart disease. It was derived from the long-running Framingham Heart Study, which has tracked cardiovascular health outcomes in multiple generations of participants since 1948.

Unlike general cardiovascular risk scores, this version specifically focuses on “hard” CHD events, providing a sharper assessment for high-impact outcomes. The score incorporates multiple well-established risk factors like age, sex, cholesterol levels, blood pressure, smoking status, and diabetes, assigning each a point value that reflects its relative contribution to risk.

The Framingham Risk Score is widely used to guide preventive strategies, such as initiating statin therapy, recommending blood pressure control, and advising smoking cessation. It supports shared decision-making between clinicians and patients by presenting risk in clear numerical and percentage terms. While powerful, the score is population-based and may require adjustment for certain ethnic groups or individuals with atypical risk profiles. Nonetheless, it remains a cornerstone of preventive cardiology and is included in many major clinical guidelines worldwide.