The Framingham Risk Score was developed from the landmark Framingham Heart Study — the longest-running cardiovascular cohort study in history, initiated in 1948 in Framingham, Massachusetts with 5,209 men and women. The 10-year CVD risk prediction model was first published by Anderson and colleagues in 1991 and underwent major revisions in 1998 (Wilson et al.) and 2008 (D'Agostino et al.). The Framingham study has produced over 3,000 publications and identified virtually every major cardiovascular risk factor. The 2008 model (using total and HDL cholesterol, systolic BP, BP treatment, diabetes, and smoking) remains the most widely used general CVD risk prediction tool globally, forming the basis for cholesterol and antihypertensive treatment guidelines.