HAS-BLED

Bleeding risk on anticoagulation

Uncontrolled hypertension (SBP > 160)

Abnormal renal function

Abnormal liver function

History of stroke

Bleeding history or predisposition

Labile INR (if on warfarin)

Age over 65

Antiplatelet or NSAID use

Alcohol use (≥8 drinks/week)

Evidence

Original publication

Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJGM, Lip GYH. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation.

Chest, 2010

Open source

Validation

Lip GYH, Frison L, Halperin JL, Lane DA. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED score.

Journal of the American College of Cardiology, 2011

Open source

Guideline

Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation (developed with EACTS) — recommends structured bleeding-risk assessment and identifies HAS-BLED ≥3 as flagging modifiable risk factors and closer review, not withholding anticoagulation.

European Heart Journal, 2021

Open source

Last reviewed: 2026-09

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