Framingham Risk Score Calculator

Age affects the point total in three separate ways at once: it has its own age-band points, it determines which column of the cholesterol table applies (the same cholesterol level scores fewer points as age rises), and it determines which column of the smoking table applies (smoking is penalized more heavily at younger ages). Cholesterol, HDL, and blood pressure each only affect their own single table and move the score in one consistent direction as they rise or fall -- age's three-way interaction makes its net effect more complex than a simple "higher is worse" rule.

No, and that is intentional rather than an oversight. The NIH/NCEP ATP III point system this calculator implements does not include diabetes as a scored risk factor. Instead, ATP III guidelines treat a diabetes diagnosis as an automatic "CHD risk-equivalent" -- meaning diabetic patients are managed as high cardiovascular risk regardless of what their Framingham point total would otherwise show, bypassing this calculator's score entirely.

The Framingham point tables use separate columns for five different age bands (20-39, 40-49, 50-59, 60-69, 70-79) because a given cholesterol level or smoking habit carries less RELATIVE additional risk in an older patient, whose baseline 10-year risk from age alone is already substantial, than in a younger patient whose baseline risk would otherwise be very low. This is a real feature of the published Framingham point system, not a calculator quirk.

Not fully. The published NIH/NCEP ATP III point tables extend age coverage from 20 to 79, which is why this calculator accepts that range, but the original Wilson et al. 1998 cohort the model was derived and validated on covered only ages 30 to 74. An estimate for a patient in their early 20s or late 70s extrapolates beyond the population the equations were built from and should be interpreted with added caution.