Important Caveats To Consider


As per the FAQs, this calculator should not be used to categorize patients into specific risk categories nor to identify specfic risk factor targets as these are arbitrary, do not use evidence from RCTs, and do not incorporate patient values or preferences.

Do not use the calculator sliders to make an estimate of the benefit of treatment

Changing the calculator sliders and/or buttons could, in theory, be used to show an estimate of benefit by just sliding them back to numbers or categories of lower risk. Unfortunately, this doesn't appear to be an accurate way to calculate estimates of benefits. The exception may be smoking, where likely the best way (as there are no RCTs of stopping smoking) to demonstrate the benefit of quitting smoking is to unclick smoking and use this to show the potential CVD benefit of stopping smoking. Most studies suggest the cardiovascular risks associated with smoking are reversed after 5-10 years of not smoking. To get an estimate of the potential cardiovascular benefit of other interventions, click on the specific intervention (BP, activity, statins, etc) below the risk sliders.

Do not use the calculator to make estimates for patients above age 80 as the relation between increases in the risk factors used in most calculators and increased risk of CVD do not seem to hold

Evidence suggests for younger people, there does appear to be an association between changes in risk factors and the risk of cardiovascular events and thus is the rationale for the use of risk calculators. However, this does not appear to be the case in patients over the age of 80 so refrain from using this calculator to estimate risk in this patient population. BMJ 2009;338:a3083 doi:10.1136/bmj.a3083

Do not use the calculator to make estimates for patients already receiving treatment except when using ASCVD

The Framingham database is not designed to calculate risk if patients are already being treated with a drug that lowers blood pressure or some other surrogate marker. Previous untreated numbers should be used. For the ASCVD calculations one can add in if the person is on treatment for blood pressure.