QRISK3

10 year risk of a heart attack or stroke. Open the calculator

Has QRISK®3 been validated?

Yes. Validatation of the underlying algorithm is described in the academic paper linked on the publications page. The software used to create this site has been tested using millions of randomly generated patient data (not real patient data). Scores on this data match those generated by the statistical software used in the validation of the algorithm described in the academic paper.

What is the QRISK®3 score?

  • QRISK®3 is the new name for a well-established cardiovascular disease (CVD) risk score, the latest version of a score which has been in use across the NHS since 2009. It is designed to identify people at high risk of developing CVD who need to be recalled and assessed in more detail to reduce their risk of developing CVD.
  • The score estimates the risk of a person developing CVD over the next 10 years.
  • It has been specifically developed by doctors and academics for use in the UK.
  • The academic research which underpins the score is described in publications listed on the 'Publications' page.
  • The research was done using the QResearch anonymised medical research database which consists of the electronic health records of over 10 million patients registered with 550 general practices using the EMIS clinical computer system of whom 2 million contributed to the QResearch database.
  • All medical decisions relating to this score need to be taken by a patient in consultation with their doctor. The authors, of the academic papers, and Endeavour Predict CIC accept no responsibility for clinical use or misuse of the score.

What is cardiovascular disease?

Cardiovascular disease is a term used by doctors to refer to a collection of diseases such as:
  • Stroke
  • Transient ischaemic attack
  • Myocardial infarction or heart attacks
  • Angina

What does 10 year risk of cardiovascular disease mean and why is it important?

  • 10 year risk of cardiovascular disease means the risk of someone developing cardiovascular disease over the next ten years.
  • If someone has a 10 year QRISK®3 score of 20% then in a crowd of 100 people like them, on average 20 people would get cardiovascular disease over the next 10 years. Or put another way, they have a 'one in five' chance of getting cardiovascular disease over the next 10 years.

How can I work out my risk?

  • You can use this QRISK®3 web calculator to estimate your risk.
  • Note though that this is just an estimate and that if you do not know some of the information needed for the calculator (like your blood pressure) then it will substitute population average values for someone of your age and sex so the result is just a guide.
  • If you are concerned about estimated risk then you can see a doctor or nurse for a full risk assessment.
  • Your doctor will have a way of identifying who needs to be assessed based on information already present in your electronic health record and may contact you if you need a review.

What is body mass index and how is it measured?

  • Body mass index is a number calculated from your height and weight.
  • It is the weight in kilograms divided by the height in metres squared.
  • Conventionally a person is considered to be obese if they have a body mass index over 30 kg/m2

What does 'family history of premature coronary heart disease in a first degree relative' mean?

  • You have a positive family history if you have a mother, father, brother or sister who has had a heart attack or 'angina' under the age of 60.
  • If you have a positive family history it will give you an increased risk so it is even more important that you try to have a healthy lifestyle -- i.e. don't smoke or aren't overweight, do exercise etc.

Which people can have a QRISK®3 cardiovascular score calculated?

  • You can use QRISK®3 if you are aged between 25 and 84 years unless you have had a heart attack, angina, stroke or transient ischaemic attack.

Why does the score need a postcode?

  • Cardiovascular risk varies according to where people live and the score takes account of this for us. The postcode is used to calculate the score only. The information is not retained by the website.

I am on blood pressure treatment and I notice that my risk is higher than it would be had I not been taking blood pressure treatment. Why is this?

  • Blood pressure treatment lowers your blood pressure and reduces your risk of heart disease and stroke.
  • The fact that you are taking blood pressure treatment means that you have already been identified by your doctor as someone needing treatment which automatically puts you in a higher risk group.
  • The treatment itself isn't increasing your risk but is acting as a marker for the fact that your underlying risk is higher.

What is the Townsend score, what does it measure and why was it used?

  • The Townsend score is a measure of material deprivation based on where a person lives and obtained using their postcode and includes four variables obtained from census data: unemployment (lack of material resources and insecurity), overcrowding (material living conditions), lack of owner occupied accommodation (a proxy indicator of wealth) and lack of car ownership (a proxy indicator of income).
  • This score is considered the best indicator of material deprivation currently available and has been widely used in medical research including a range of studies conducted on the QResearch database.

Where patients are on antihypertensive treatment, should a pre-treatment blood pressure be used when calculating their risk?

  • No. QRISK®3 has been designed such that if a patient is taking antihypertensive medication then their current blood pressure on treatment can be used rather than a pre-treatment value.

What is the difference between an 'estimated' QRISK®3 CVD score and an 'actual' QRISK®3 score?

  • An 'estimated' score is one for which some data is not known and the corresponding question on the form is left blank.
  • An 'actual' score is one for which all data is present and correctly entered.

There is a sense in which any QRISK®3 score is always an estimate -- individuals are just that, and may have other risk factors or benefits that we have not taken into account.

Why is it important to measure HDL cholesterol in order to get the best estimate of CVD risk?

  • It is the ratio of total cholesterol to HDL cholesterol that is the best predictor of risk, better than either total cholesterol or HDL cholesterol alone.
  • Someone with a total cholesterol of 7.5mmols/l and an HDL cholesterol of 1.8mmols/l has a ratio of 4.2 which is associated with a considerably lower risk than someone with a total cholesterol of 5.8mmols/l and an HDL of 0.8 (ratio 7.2).

What about other factors which may increase CVD risk but are either not included in the score or fully accounted for?

  • There are other factors which can increase CVD risk which are not directly accounted for in the QRISK®3 algorithm.
  • These include, for example, alcohol excess, poor diet, lack of exercise and extreme obesity. These factors will all tend to increase risk of cardiovascular disease.

Has NICE recommended QRISK®3?

  • Yes -- it is their risk score of choice in their 2023 draft guidance.