University of Minnesota

Risk Assessment Tools

The multitude of tables and devices developed for estimating an individual’s risk of a future coronary event exceeds capacity for description here, but most of these derive directly or indirectly from the Coronary Risk Handbook prepared from the multivariate analyses and cross-tabulated risk of a coronary event by Tavia Gordon and William Kannel from the Framingham Study as published by the American Heart Association in 1973. The handbook featured tabulations of absolute six-year risk per hundred for coronary events among men and women ages 35 to 65, by class of smoker or non-smoker, with or without non-specific ECG findings, and in detailed tables according to increasing systolic blood pressure and the presence or absence of glucose intolerance. It also provided tables of ideal weight and a management form for treatment and follow-up.

The AHA reproduced and distributed this popular handbook by the tens of thousands until more sophisticated systems appeared for practitioners’ use. Now individuals can enter their personal data and receive their risk estimates via the internet. The Framingham Risk Score, based on the study’s 10-year and 30-year data, for men and women, for primary or recurrent events and mortality, is the most-used base for calculating risk for individuals or, appropriately or not, for population comparisons, and can also be downloaded from the internet.