The Framingham Heart Disease Epidemiology Study produced a strategy to calculate the risk of developing one of the following conditions in the next 10 years:

To calculate this risk, the score sheet looks at uncontrollable and controllable risk factors, including:

• Age
• Gender
• Total cholesterol
• HDL cholesterol
• Systolic blood pressure (and whether a person is being treated for high blood pressure)
• Whether or not a person smokes

Each of these factors is assigned a point value. These points are added and then divided by the total risk factors present in a person of similar age and gender who is at low risk. The final risk is presented as a multiple of the ideal low-risk person.

In other words, a person with a reading of 5 would be five times more likely to suffer a major heart-related problem in the next 10 years than someone of similar age and gender who is at low risk.

As researchers learn more, they are working to identify new risk factors for heart disease, although these are not yet part of the standard Framingham risk-assessment model. These new risk factors include:

• Homocysteine. Framingham research has found that high levels of homocysteine may contribute to heart disease, stroke and reduced blood flow to the hands and feet. Homocysteine may contribute to the buildup of fatty substances in the arteries, increase platelet “stickiness” and make blood vessels less flexible. The level of homocysteine appears to have genetic factors and dietary factors, and it can be lowered through dietary changes or taking folic acid and vitamin B supplements.
  
  
• Lipoprotein(a) or Lp(a). This lipoprotein is a component of LDL cholesterol. It is thought to inhibit the breakup of blood clots.
  
  
• Infectious disease. Framingham investigators are pursuing links between heart disease and viruses, which may harm blood vessel walls and aggravate atherosclerosis. Such diseases include chlamydia, H. pylori and cytomegalovirus.