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Long-Term Cardiovascular Risk

30-Year Cardiovascular Risk

Estimate your 30-year absolute risk of developing cardiovascular disease using the Pencina 2009 Framingham extension, a Fine-Gray competing-risks model validated for adults aged 20–60 with no prior CVD. Compare your curve against an "optimal" and "normal" risk-factor profile.

Patient Parameters

mmHg
mg/dL
mg/dL

Enter your risk factors and tap Calculate to project your 30-year cardiovascular risk curve.

A 30-year projection is a planning horizon.

The gap between your curve and the optimal curve is the space where preventive medicine actually lives. If your projection is higher than you'd like, a full cardiometabolic evaluation translates it into concrete, prioritized interventions.

See evaluation packages Schedule a consultation

Evidence & Sources

  1. Pencina MJ, D'Agostino RB Sr, Larson MG, Massaro JM, Vasan RS. Circulation. 2009;119(24):3078–3084. Predicting the 30-year risk of cardiovascular disease: the Framingham Heart Study.
  2. Fine JP, Gray RJ. J Am Stat Assoc. 1999;94(446):496-509. A proportional hazards model for the subdistribution of a competing risk.
  3. Framingham Heart Study cohort data underlying the model, public documentation.

Clinical Disclaimer: This calculator is for educational and decision-support purposes only. It is derived from the Pencina 30-year Framingham model and is intended for adults aged 20–60 with no prior CVD. Outputs are absolute cumulative incidence accounting for competing mortality. Absolute risk is capped at a display maximum of 99.9%. The Framingham cohort was predominantly white/European; accuracy may vary in other populations. This tool does not substitute for individualized clinical judgment.

About 30-Year CVD Risk

Why 30 years instead of the usual 10?

The standard 10-year estimates (MESA, ASCVD) underestimate lifetime risk in younger adults because heart disease develops over decades. A healthy 35-year-old with slightly elevated cholesterol looks "low risk" on a 10-year calculator, but their 30-year trajectory may be meaningfully different. The Pencina model was designed specifically to expose that long-horizon gap.

What's the difference between 'Full CVD' and 'Hard CVD'?

Full CVD includes anything vascular, heart attack, stroke, angina, transient ischemic attack, heart failure, and peripheral vascular disease. Hard CVD is the narrower endpoint: heart attack, stroke, or CHD death. Hard CVD is what most cardiovascular medications were trialed to prevent; full CVD is a broader picture of vascular aging.

What is 'competing-risks methodology'?

Over 30 years, a lot of people die from non-cardiovascular causes (cancer, accidents, etc.), and those deaths prevent them from ever having a heart attack. Naive Cox models overestimate long-term risk because they ignore this. The Fine-Gray model explicitly accounts for competing mortality, giving a more honest absolute risk estimate.

What are 'optimal' and 'normal' profiles?

The calculator shows three curves: yours, an optimal profile (BP ~110, TC ~160, HDL ~60, no smoking or diabetes) and a normal profile (BP ~125, TC ~180, HDL ~45). The optimal curve shows the floor, how low your risk could go with perfect modifiable factors at your age and sex. The gap is the work.

I'm older than 60 or younger than 20, can I still use this?

The Pencina model was derived from adults aged 20–60. Outside that range it is an extrapolation we don't show. For ages 45–85, use the MESA 10-year CHD calculator, which is validated in that range and also computes coronary age.