Predicting and managing the risk of heart disease

Estimating your risk of cardiovascular disease

Predicting a person’s cardiovascular risk is very important for healthcare professionals in preventing cardiovascular disease. SCORE (Systemic Coronary Risk Estimation) is an easy-to-use risk assessment tool developed to support healthcare professionals in assessing their patient’s risk of dying from cardiovascular (heart and circulatory) causes, such as myocardial infarction (heart attack), heart failure (incapacity of the heart to pump blood), or stroke (sudden blockage of a blood vessel carrying oxygen and nutrients) within the next ten years. Ask your doctor for a personalised risk assessment.

Predicting a person’s cardiovascular risk is very important for healthcare professionals in preventing cardiovascular disease. There are many methods or tools available that can be used to predict this risk. These tools take several risk factors into account in calculating your risk score. Risk factors are attributes, characteristics or exposures of a person that play a role in the development of cardiovascular disease, for example your smoking status or your blood pressure.

A highly recommended method for risk prediction is SCORE (Systemic Coronary Risk Estimation). SCORE is an easy-to-use tool developed to support healthcare professionals in assessing their patient’s risk of dying from a myocardial infarction (heart attack), heart failure or a stroke over the next ten years. It includes multiple risk factors, most of which you can address, such as your blood pressure, blood cholesterol (level of fats in your blood) and smoking habits. It also includes risk factors that you cannot change, such as your age and your gender. SCORE shows you how these risk factors work together to produce your overall risk (expressed as a percentage) and it highlights which risk factors can be addressed to lower your risk. The calculations can be done by using the SCORE risk charts or through the interactive Heartscore online tool. SCORE is designed for use with “healthy” people, which means the charts are not recommended for use with patients who already have heart disease or had a stroke in the past.

The risk score can fall into four categories: low (<1%), moderate (≥1 and <5%), high (≥5 and <10%) and very high (≥10%). It is important to discuss with your doctor what this means and what you can do to lower your risk. Besides calculating the risk over the next ten years, SCORE also translates the risk score into a “risk age”. This is mostly used by healthcare professionals when talking about risk in younger individuals as younger people can have a low risk score but still have a high relative risk and a higher risk age. If your risk age is higher than your actual age, it means that your risk is higher than a healthy level of risk for your age. Two examples to clarify:

  • A 40 year old man who smokes, has a blood pressure of 180/82 and a total cholesterol of 6. His risk score is 4%, which puts him in the low risk category. This is correct because the assessment looks for the risk within the next ten years. However, given his young age, his relative risk is high. This translates itself into a risk age of 60 years old.
  • A 50 year old women has a blood pressure of 178/80, a cholesterol level of 7.5 mmol/L or 136 mg/dL and she is a smoker. Her risk score is 2%. She is also considered at low risk for the next ten years. Her risk age however is 71 years old.

Take a look at the recommended advice for a healthy lifestyle to see how you can lower your risk. You should ask your doctor or healthcare professional for a personal assessment with the SCORE charts or the Heartscore tool .

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