Health

HAS-BLED Score Calculator

Estimate 1-year major bleeding risk in atrial fibrillation patients on anticoagulation.

Hypertension (uncontrolled, SBP >160 mmHg)

Abnormal renal function (dialysis, transplant, Cr >2.26 mg/dL)

Abnormal liver function (cirrhosis, bilirubin >2× ULN, AST/ALT >3× ULN)

Stroke history

Bleeding history or predisposition (anemia)

Labile INR (TTR <60%)

Elderly (age >65)

Drugs (antiplatelet, NSAID)

Alcohol ≥8 drinks/week

HAS-BLED: Hypertension, Abnormal renal/liver function, Stroke, Bleeding, Labile INR, Elderly, Drugs/alcohol — 1 point each (max 9)

What Is the HAS-BLED Score?

HAS-BLED was developed by Pisters and colleagues in 2010 from the Euro Heart Survey to predict major bleeding risk in atrial fibrillation (AF) patients receiving anticoagulation. It is recommended by both the European Society of Cardiology and the American College of Cardiology guidelines.

Risk Stratification (annual major bleeding rate)

0 — 1.13% risk
1 — 1.02% risk
2 — 1.88% risk
3 — 3.74% risk (high risk threshold)
4 — 8.70% risk
≥5 — >12% risk

Clinical Use

A HAS-BLED ≥3 identifies high-risk patients who require closer monitoring and aggressive correction of modifiable bleeding risk factors. Importantly, a high HAS-BLED score is not an automatic contraindication to anticoagulation — most AF patients benefit from anticoagulation even with elevated HAS-BLED, because stroke risk usually outweighs bleeding risk.