The two equations and the guideline that uses them, each with its paper.
SCORE2
Ages 40 to 69, without diabetes or earlier cardiovascular disease
The risk model of the 2021 European guideline. It estimates the chance of a fatal or non-fatal heart attack or stroke in the next ten years from sex, age, smoking, systolic blood pressure, total cholesterol and HDL cholesterol. It was derived from 45 cohorts in 13 countries (677,684 people, 30,121 events) and validated in another 1,133,181 people, and it is calibrated to four regions of Europe by their cardiovascular death rates; the Netherlands is in the low-risk region.
This page uses the published equation, with the coefficients, baseline survival and regional scales from the paper's supplement. The paper's own worked example (a man of 50 who smokes, 140 mmHg, cholesterol 5.5 and HDL 1.3: 5.9 % in a low-risk country) is reproduced exactly.
Source: SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. European Heart Journal 42(25):2439-2454, 2021.
SCORE2-OP
Ages 70 to 89, without earlier cardiovascular disease; diabetes is one of the inputs
The companion model for older persons, with the same inputs plus diabetes. It was derived in the Norwegian CONOR study (28,503 people aged 70 to 79, 10,089 events), takes dying of other causes into account as a competing risk, and is recalibrated to the same four regions of Europe.
This page uses the published equation. Every coefficient rounds to the value printed in the paper's Table 2, and an independent implementation gives the same result on thousands of profiles.
Source: SCORE2-OP working group and ESC Cardiovascular risk collaboration. SCORE2-OP risk prediction algorithms: estimating incident cardiovascular event risk in older persons in four geographical risk regions. European Heart Journal 42(25):2455-2467, 2021.
ESC 2021 prevention guideline
The risk regions and the risk categories
The guideline divides Europe into four regions by cardiovascular mortality (low, moderate, high, very high) and reads the SCORE2 result against thresholds that move with age: under 50, a risk of 2.5 % or more is high and 7.5 % or more very high; from 50 to 69 the thresholds are 5 % and 10 %; from 70 they are 7.5 % and 15 %. The category on this page follows that table. What a category means for you is a conversation with your doctor, not a line on a website.
Source: Visseren FLJ, Mach F, Smulders YM, et al.. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal 42(34):3227-3337, 2021.
This page only computes the published equations. The models, their validation and their calibration are the work of the SCORE2 working group and the ESC Cardiovascular Risk Collaboration; the papers are linked below.
This calculator is for education and awareness. It estimates the risk of a group of people with values like yours; it does not know you. It is not medical advice and never replaces a conversation with your doctor, who can measure what this page can only ask.
