The official Canadian cardiovascular risk calculator. Uses the CCS 2016 dyslipidemia guidelines with mmol/L cholesterol units — as used by Canadian physicians and pharmacists in clinical practice.
Anderson TJ et al., Can J Cardiol 2016 · Ages 30–75+
The Canadian Framingham Risk Score (FRS) is the cardiovascular risk tool endorsed by the Canadian Cardiovascular Society (CCS) for primary prevention in Canadian clinical practice. It is based on the D'Agostino 2008 Framingham equations adapted to a point-based format with mmol/L cholesterol units — the standard used across Canadian laboratories, pharmacies, and physician offices.
The most recent update is the 2016 CCS Dyslipidemia Guidelines (Anderson TJ et al., Can J Cardiol 2016;32:1263–82), which uses three risk tiers — low, intermediate, and high — with specific LDL targets and statin initiation thresholds for each tier. This differs from the U.S. system, which uses four tiers and focuses on percentage reduction rather than absolute LDL targets.
Uses mmol/L for cholesterol — as reported on Canadian blood test results. No conversion needed if you have a Canadian lab report.
Shows your score point-by-point — exactly as Canadian physicians calculate it manually using the CCS chart. Transparent and auditable.
Provides your CCS-recommended LDL target and statin initiation threshold based on your risk category — not just a risk percentage.
| Feature | 🍁 Canadian FRS | 🇺🇸 US ASCVD |
|---|---|---|
| Guideline | CCS 2016 | ACC/AHA 2013 |
| Cholesterol units | mmol/L | mg/dL |
| Method | Point-based table | Continuous equations |
| Risk categories | 3 (Low / Intermediate / High) | 4 (Low / Borderline / Intermediate / High) |
| Family history | Doubles the score | Not in equation |
| Treatment goal | Absolute LDL target | % LDL reduction |
| Statin threshold | Intermediate ≥10% | Intermediate ≥7.5% |
| Age range | 30–75+ | 40–79 |
A key feature of the Canadian FRS that differs from U.S. tools is the family history doubling rule. If you have a first-degree relative (parent, sibling, or child) who experienced cardiovascular disease before age 55 (male) or age 65 (female), the CCS guidelines recommend doubling your calculated FRS. For example, if your raw score gives 9% (low risk), doubling to 18% reclassifies you as intermediate risk, which changes your LDL target and statin recommendation.
This calculator applies the doubling automatically when you select "Yes" for family history and flags it clearly in your results.
Canada adopted the SI (International System) unit for clinical chemistry, so cholesterol is reported in millimoles per litre (mmol/L) rather than milligrams per decilitre (mg/dL) used in the United States. All Canadian laboratory reports, pharmacy printouts, and clinical guidelines use mmol/L. If you only have mg/dL values from a U.S. test, divide by 38.67 to convert, or use the conversion table in the sidebar.
The CCS 2016 guidelines recommend considering statin therapy when your 10-year FRS reaches the intermediate range (≥10%), provided your LDL is above the treatment threshold for your category. At high risk (≥20%), statin therapy is generally recommended. However, the actual decision also depends on your LDL level, other risk modifiers, and a shared decision-making conversation with your physician.
The CCS 2016 guidelines recommend the Framingham Risk Score for primary prevention decisions in Canada. However, research published in CMAJ (Hippisley-Cox et al.) has shown that both the FRS and US Pooled Cohort Equations tend to overestimate cardiovascular risk in contemporary Canadian populations, particularly in Ontario. Your physician may use clinical judgment to adjust treatment decisions accordingly.
The Cardiac Risk Calculator on this site uses the continuous D'Agostino 2008 Framingham equations designed for the U.S. primary care setting, with mg/dL inputs. This Canadian FRS page uses the point-based adaptation endorsed by the CCS with mmol/L inputs — the version actually used in Canadian clinical practice. The underlying mathematical framework is the same, but the Canadian adaptation uses discrete point tables calibrated for Canadian guideline thresholds.