Cardiovascular & clot risk

HAS-BLED

Identify bleeding-risk factors that warrant review in adults with atrial fibrillation.

Intended population: Adults with atrial fibrillation; intended to support risk-factor modification and follow-up.

A high score is a prompt to address modifiable risks and review more often, not a reason by itself to withhold anticoagulation.
Annual bleeding percentages vary by setting and treatment and are not estimated here. Unknown INR control must not be entered as normal.

Adult with atrial fibrillation

Age (years)

Uncontrolled hypertension: systolic BP >160 mmHg

Chronic dialysis, kidney transplant, or creatinine ≥200 µmol/L (≈2.26 mg/dL)

Cirrhosis, or bilirubin >2× normal together with AST/ALT/ALP >3× normal

Previous stroke

Previous major bleeding or predisposition (such as anemia)

Labile INR on a vitamin K antagonist

Concomitant antiplatelet medication or NSAID

Alcohol excess (>8 units/week; confirm local unit definition)

Sources and scoring references

Pisters et al.: original HAS-BLED study ↗2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline ↗

Implementation references reviewed October 28, 2026. Verify applicability and unusual or treatment-changing results against the linked references and local guidance.