Know and understand your cardiovascular risk score

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By Dr. Kevin Moore

Heart disease is the leading cause of death in America for both men and women. According to Centers for Disease Control and Prevention reports, heart disease kills more than 625,000 Americans annually, far exceeding the number of deaths from all types of cancer combined. Another 140,000 Americans die each year of strokes.

Recent advances in our overall understanding of heart disease combined with new strategies for prevention, diagnosing, and treating heart disease can dramatically effect patient care and outcomes. Prevention is the mainstay for helping people live longer and more active lives.

Most Americans can name the risk factors associated with heart disease. There are both changeable and unchangeable risk factors. Unchangeable risk factors include age, gender, race/ethnicity, and family history. Changeable risk factors include smoking, high blood pressure, high cholesterol, and diabetes. By actively managing these changeable risk factors, patients working with their primary care provider can significantly lower their overall risk for developing heart disease.

In 2013, the American Heart Association and the American College of Cardiology working with the National Cholesterol Education Program developed and released new clinical practice guidelines for the prevention of heart disease. One of the mainstays of these new clinical practice guidelines was to be able to calculate the 10-year cardiovascular risk score for patients between the ages of 40 and 79. Knowing this risk score allows both the patient and primary care provider to tailor preventive strategies like cholesterol lowering and low-dose aspirin therapy to decrease overall risk.

Let us use a typical patient as an example: a 52-year-old white male with no history of diabetes or high blood pressure that smokes, has a resting blood pressure of 138/84, and a total cholesterol of 192 with a heart-healthy HDL cholesterol of 34. His 10-year cardiovascular risk score for a heart attack or stroke is 13.5 percent. This means that if we took 100 men with similar risk factors, blood pressure, cholesterol scores, and smoking history, that almost 14 of them would have either a heart attack or stroke in the next 10 years.

The good news is that effectively managing his risk factors to include smoking cessation, cholesterol treatment (despite what may appear as relatively normal looking cholesterol numbers), and aspirin therapy could lower his 10-year risk to a very normal 2.6 percent.

It is relatively easy to learn your 10-year cardiovascular risk score. The American College of Cardiology has an on-line tool for both patients and clinicians at www.cvriskcalculator.com that uses easily obtained data to determine a patient’s risk. Equally important is to work with a primary care provider to develop both short- and long-term strategies to improve your heart health and enjoy a long and active life.