Knowing if you have heart attack risk factors is a good starting point, but there are several methods that can be used to actually calculate how those risk factors—and other information—equate to a low, medium or high risk of having a heart attack.
Individuals with known risk factors for heart disease and heart attack, especially those with a family history, may find use of these tools particularly helpful. If you’re over age 40, it's also a good idea to get a better sense of your risk.
These tools are not designed for people with diabetes or existing cardiovascular disease. Those individuals already have a high risk of heart attack and need to work closely with their doctors to keep heart and blood vessels in good condition.
Tool #1: Framingham Risk Score
For years, the gold standard to measure the risk of a heart attack in people without symptoms of coronary heart disease (CHD) was the Framingham Risk Score. The tool is based on the Framingham Heart Study, which, starting in 1948, tracked several generations living in Framingham, Massachusetts for the development of cardiovascular diseases. The landmark study revealed much of what we know today about cardiovascular risk factors.
The Framingham Risk Score takes into account traditional heart attack risk factors, including:
- cholesterol levels
- smoking history
- blood pressure
To obtain your score, use this online tool hosted by the National Cholesterol Education Program, part of the National Heart, Lung, and Blood Institute:
Plug in your age, gender, total cholesterol, HDL cholesterol, smoking habits, systolic blood pressure and whether or not you are on high blood pressure medication. Then, submit your information.
The score you receive is an estimate of your chances of a heart attack risk within the next 10 years. Generally, having a score of 20 percent or more is considered high risk; 10 to 20 percent is intermediate risk; and less than 10 percent is low risk.
Tool #2: Reynolds Risk Score or the Modified Framingham Risk Score
Even if your original Framingham score doesn't put you in a high-risk category, many experts recommend that you also calculate your total cardiovascular risk with the Modified Framingham Risk Score (talk to your doctor) or the Reynolds Score.
Although guidelines still support the original Framingham Risk Score, the additional risk scoring systems can give you a more complete sense of your real risks.
The reason: While valuable, researchers have pointed out several limitations of the original Framingham Scoring System: It predicts only heart attack risk, not other serious cardiovascular events such as stroke or heart failure. It doesn't include some important risk factors that play into CHD, nor does it assess risk beyond 10 years.
Because of this, experts have developed modified forms. One, the Reynolds Risk Score, takes the Framingham assessment and adds two factors to predict 10-year risk of a future heart attack, stroke or other major heart event. The first, high-sensitivity C-reactive protein (hsCRP), is a protein in blood that is a marker for inflammation, a known risk factor for heart disease. The second is family history of premature CHD, defined as having a parent who had a heart attack before age 60.
The Reynolds Risk Score has its own website, which you can visit to plug in your information: reynoldsriskscore.org
The Modified Framingham Risk Score, available through your primary care physician's office, measures your risk of not only a heart attack, but also a stroke, heart failure, and intermittent claudication (leg pain that results from narrowing of the arteries in the legs). The scoring system can also estimate your heart "age," the condition of your heart compared to your chronological age; for example, a 60 year old man might have a heart of someone 5 years younger, indicating better-than-average heart health.
More Helpful Risk Assessments
For additional heart health risk assessments based on notable research, including ones for cardiovascular disease over the next 30 years and atrial fibrillation (heart rhythm abnormalities) within 10 years, visit the Framingham Heart Study website: framinghamheartstudy.org/risk/index.html
What to Do With Your Scores
Your scores will give you and your doctor an overall idea of your cardiovascular health. Armed with this information, you and your doctor can take steps now to stave off a heart attack and more. If your risk score is intermediate to high on any of the tools, your doctor may recommend testing and medication.
A Heart Healthy Lifestyle
No matter your scores, you should take vital steps now to protect your heart health. Heart disease is the number one cause of death among men and women in the United States. While you can't change risk factors such as your gender or age, you can do plenty to reduce other contributors: