QRISK3 — 10-Year Cardiovascular Risk
Approximates the QRISK3 (UK-validated) 10-year risk of myocardial infarction or stroke. NICE NG238 recommends QRISK3 for primary prevention statin decisions in adults 25–84 years. This calculator uses additive risk weights for clinical use; for the formal logistic model use the official QRISK3 web tool. Not validated in established CVD, T1DM, eGFR <30, or familial hypercholesterolaemia.
How to use & interpret
QRISK3 estimates the 10-year risk of cardiovascular disease (heart attack or stroke) for primary prevention in adults aged 25–84 without established CVD. It includes a wide range of factors — age, sex, ethnicity, deprivation, blood pressure (and its variability), cholesterol ratio, BMI, smoking, diabetes, and several conditions such as chronic kidney disease, atrial fibrillation, rheumatoid arthritis, migraine, SLE and severe mental illness.
In UK practice (NICE), a 10-year risk of ≥10% prompts a discussion about starting a statin alongside lifestyle measures. It is not for people who already have CVD, type 1 diabetes, or familial hypercholesterolaemia, who are managed under separate guidance.
Score interpretation
→ Lifestyle advice (Mediterranean diet, exercise, smoking cessation, weight optimisation). Reassess every 5 years if untreated.
→ Atorvastatin 20 mg OD per NICE NG238 if no contraindications; intensify lifestyle change; recheck lipids and LFTs at 3 months. Consider ACR / lipid review.
→ Atorvastatin 20 mg OD (titrate to ≥40% non-HDL reduction); BP target <140/90 (or <130/80 if T2DM/CKD); aspirin only if established CVD; consider FH testing if early CHD or LDL>4.9.
Interpretation bands for the QRISK3. Apply clinical judgement and local guidance.
Frequently asked questions
What QRISK3 score means a statin should be offered?
NICE suggests discussing a statin (with lifestyle advice) when the 10-year CVD risk is 10% or higher, as part of shared decision-making rather than an automatic prescription.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Framingham Risk Score · Cardiovascular Risk
- ACC/AHA Pooled Cohort Equations — ASCVD Risk · Cardiovascular Risk
- PREVENT Cardiovascular Risk Calculator (AHA/ACC 2023) · Cardiovascular Risk
- Reynolds Risk Score for Women · Cardiovascular Risk
- SCORE2 — 10-Year CVD Risk (Age 40–69) · Cardiovascular Risk
- SCORE2-OP — 5/10-Year CVD Risk (Age ≥ 70) · Cardiovascular Risk
- Atorvastatin (CKD Cardiovascular Risk) · Cardiovascular Risk in CKD
- Icosapent Ethyl (Omega-3 — Cardiovascular Risk Reduction) · Omega-3 Fatty Acid (Purified EPA — Eicosapentaenoic Acid Ethyl Ester)
- Fluvastatin · HMG-CoA reductase inhibitor (statin)
- Pravastatin sodium · HMG-CoA reductase inhibitor (hydrophilic statin)
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Tenecteplase · Cardiovascular Emergency
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.