Know your risk of a heart attack and stroke
Publication Date:29/05/2008
Anyone over the age of 40 should have their risk of getting a heart attack or a stroke assessed, to see if they need cholesterol tests or treatment, doctors have been told. If you’re aged 40 or over, it’s worth knowing whether you're at risk of having a heart attack or a stroke. We explain who’s at risk, and what you should do if you’re worried.
What do we know already?
The risk of getting damage to your heart and blood vessels increases as you get older. This damage is called 'cardiovascular disease'. It increases the risk of having a heart attack or a stroke.
When doctors work out your chances of getting cardiovascular disease, they may talk about your 10-year risk. This is the risk of getting heart problems or a stroke at any time in the next 10 years. Your doctor will say your risk is high if you have a more than 20 percent chance of getting cardiovascular disease over 10 years.
For most people under 40, their 10-year risk of cardiovascular disease is low. But from the age of about 40 onwards, that risk starts to rise. Most people who get cardiovascular disease are 50 or over.
Apart from age, these are some of the things that increase your risk:
- Being a man
- Smoking
- Having high blood pressure
- Having high cholesterol
- Being very overweight
- Coming from certain ethnic backgrounds, especially from southern Asia
- Having a family history of cardiovascular disease (this means your father had a heart attack or a stroke before 55, or your mother had a heart attack or a stroke before 65)
- Having diabetes.
Until now, there have been no rules saying who should have a proper assessment of their risk of cardiovascular disease. You may get your risk checked if you happen to see your doctor about something else. And some people ask their doctor to check their risk. But doctors may be missing some of the people who have the biggest risk of getting cardiovascular disease.
Guidelines for doctors have now been published, to make sure everyone gets their risk of cardiovascular disease properly checked.
What does the new advice say?
The guidelines say that doctors should look at the records of all their patients over 40. They should use the records to make an estimate of who is most at risk of cardiovascular disease. These people are likely to be older men, people from certain ethnic groups, and people who have high blood pressure, high cholesterol, or who smoke.
Doctors should then ask these people to come to the surgery for a proper assessment. This is likely to include blood tests, such as tests for cholesterol. The doctor will also check the person's weight, whether they smoke, and whether they have a family history of heart disease. The doctor can then work out the patient's overall risk of cardiovascular disease.
People who have a high risk of cardiovascular disease will be offered treatment. That might include advice about diet and exercise, or drugs to lower cholesterol (usually statins).
Where does the advice come from?
The guidelines come from the National Institute of Health and Clinical Excellence, the independent body that advises the government about health care.
What does this mean for me?
If you’re over 40, it’s worth knowing whether you're at risk of getting cardiovascular disease. Your doctor should check your records over the next few years. If he or she thinks you may have an increased risk, you’ll be asked to come to the surgery and have a proper assessment. If your doctor thinks your risk is likely to be low, you may not be contacted.
This only works if your doctor knows enough about you to make a good estimate of your risk. So, if you smoke, but your doctor doesn’t know that, he or she won’t be able to take account of it. It’s important that your medical records are up-to-date.
What should I do now?
You can see from the checklist above whether you're likely to be at higher-than-average risk of cardiovascular disease. If you're worried about your risk, make an appointment to see your GP or practice nurse. They can give you more advice about your risk, and help you decide if you need further tests or treatment.
From:
National Institute for Health and Clinical Excellence. Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. May 2008. NICE clinical guideline 67. Available at http://www.nice.org.uk/cg67.
To find out more, see our information about high cholesterol, high blood pressure, heart attack, angina and strokes.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
