Harvard Heart Letter

New tool refines heart risk prediction

Adding C-reactive protein and family history modernizes and improves the standard risk tool.

When should the tried-and-true make way for something new? That's a question we all face from time to time, whether it has to do with Thanksgiving traditions or new business practices. In cardiology, one of the tried-and-trues is the Framingham risk score. It has been used millions of times to estimate an individual's chances of having a heart attack. Why bother with such a seemingly macabre task? Knowing your risk can help you and your doctor take steps against the prediction coming true without overdoing it.

The Framingham risk score uses just six bits of information — age, gender, total cholesterol, HDL cholesterol, smoking status, and systolic blood pressure — to generate one's chances of having a heart attack over the next 10 years. To make the scores more useful, they've been grouped into categories: A score under 5% represents low heart attack risk; 5%–9.9%, moderate risk; 10%–19.9%, moderately high risk; and 20% and above, high risk.

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