A recalibrated cardiovascular disease (CVD) risk chart for the German population, Systematic Coronary Risk Evaluation (SCORE) Germany, was developed in 2005. We evaluated the risk prediction by SCORE Germany in two large population-based surveys. STUDY POPULATIONS AND METHODS: We applied the SCORE Germany risk function to men and women, aged 40-65 years, who participated in surveys of the Study of Health in Pomerania (SHIP), north-east Germany or the Cooperative Health Research in the Augsburg Region (KORA) study (southern Germany). The prevalence of single risk factor combinations and of the SCORE Germany risk prediction categories was assessed. The 10-year risk of fatal CVD predicted by SCORE Germany (P) was evaluated against the risk observed in the general population using official mortality data (O). RESULTS: Less than one in 25 women in the two studies had a high-predicted 10-year risk of fatal CVD (> or =5%), whereas one in three men in SHIP and about one in four men in KORA belonged to this risk group. The age-specific predicted risk of fatal CVD was consistently higher for men and women from SHIP than from KORA. On comparison, the P/O ratio of 10-year CVD risks was close to unity and tended to decline with higher age in the both studies. CONCLUSION: Overestimations of risks with the original SCORE model are reduced mostly with SCORE Germany. Differences in risk factors and CVD risk between populations within Germany are reflected properly by risk predictions with SCORE Germany. The recalibrated risk chart seems to be suited for use in German clinical practice.