Evaluation of cardiovascular risk using the Framingham risk score among adults attending a tertiary care centre: a cross-sectional study

Abstract

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in India. The Framingham risk score (FRS) is a validated tool for estimating 10-year CVD risk; however, data on its applicability in tertiary care settings in Kerala are scarce.

Objective: To evaluate the 10-year cardiovascular risk profile of adults attending a tertiary care centre using the FRS and to identify factors associated with high cardiovascular risk.

Methods: A cross-sectional study was conducted among 450 adults aged 30–75 years attending outpatient departments of a tertiary care centre in Thiruvananthapuram, Kerala, from January to June 2026. The FRS was calculated using standard variables: age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, antihypertensive treatment status, and smoking status. Participants were categorised as low (<10%), intermediate (10-19%), or high (≥20%) risk.

Results: The mean age of participants was 52.4±11.8 years (218 males, 232 females). The overall mean FRS was 17.4±9.2%. A total of 154 participants (34.2%) were categorised as high risk (FRS≥20%), 184 (40.9%) as intermediate risk, and 112 (24.9%) as low risk. Males had a significantly higher mean FRS than females (19.8% vs. 15.3%, p=0.003). Hypertension (OR 2.87; 95% CI 2.14-4.55), diabetes mellitus (OR=2.31), and current smoking (OR=1.94) were the strongest independent predictors of high cardiovascular risk.

Conclusions: A substantial proportion of adults attending this tertiary care centre are at high cardiovascular risk. The FRS is an effective and feasible screening tool in this setting. Targeted interventions addressing hypertension, diabetes, and tobacco use are urgently needed to reduce the CVD burden in this population.