Cardiovascular disease is a general term for conditions affecting the heart, blood vessels or both. Examples of cardiovascular disease are:
- Heart attack
- Stroke or Transient ischaemic attack (TIA)
- Coronary Heart disease
- Angina
- Heart Failure
- Peripheral arterial disease (PAD)
It is usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots.
The exact cause of CVD is not clear but there are many factors that can increase your risk. It is commonly known that the amount of cholesterol in your blood can increase your risk of developing CVD. Which is why it is important to have a blood test to check your current cholesterol (lipid) levels.
However, cholesterol is only one part of the risk factors. Your clinician will use a QRISK2 tool to calculate the likelihood of you having a stroke or heart attack in the next 10 years. The more risk factors you have, the higher the chance of cardiovascular disease. Even if you have low cholesterol you may still have a high QRISK2 score.
Risk factors include:
- age
- sex – men are more likely to get CVD earlier than women
- ethnic group
- body mass index – being over weight will increase your risk.
- current or ex smoker
- family history of heart disease
- high blood pressure
- high blood cholesterol levels
- alcohol consumption
- if you have certain long term conditions – such as Diabetes, Chronic Kidney Disease, Rheumatoid arthritis and atrial fibrillation.
Your QRISK2 score will tell us whether you are at low, moderate of high risk of developing in next 10 years.
Low risk – QRISK2 score of less than 10%
This means that you have less than a one in ten chance of having a stroke or heart attack in the next 10 years.
Moderate risk – QRISK2 of 10-20%
This means that you have between a one to two in ten chance of having a stroke or heart attack in the next 10 years.
High risk – QRISK2 score of more than 20%
This means that you have at least a two in ten chance of having a stroke of heart attack in the next 10 years
If your score is more than 10% (moderate risk or above), NICE (National Institute for Health and Care Excellence) guidance suggests you should recommended lifestyle changes and the option of starting statin or lipid lowering medication.
- Eat a well-balanced healthy diet – Increase your intake of fruit & vegetables and reduce the amount of saturated fat, sugar and salt. Visit Eat Well
- Stop smoking – Livewell Derby can offer help and support with giving up smoking
- Reduce alcohol intake – men and women are advised to not drink more than 14 units of alcohol per week. A unit calculator can help you determine your current alcohol intake.
- Monitor your weight – if your BMI should be between 20-25. A BMI calculator will help to calculate your current weight. If you are overweight, consider ways to reduce your BMI. Livewell Derby can offer help and support with losing weight.
- Exercise regularly – Walking for Health is a good way to introductory to exercise
- Take blood pressure medication if you have high blood pressure
What is cholesterol
Cholesterol is a fatty substance found in your blood cells. There are two main types of cholesterol:
- good cholesterol (HDL – high-density lipoproteins) – carries cholesterol to the liver for excretion.
- bad cholesterol (LDL – low-density lipoproteins) – can lead to the build up of fatty substance in your blood vessels creating a blockage in the flow of blood to and from your heart.
High levels of ‘bad cholesterol’ can increase your risk of cardiovascular disease. Statins can help to reduce your cholesterol level and protect the insides of the artery walls.
Your clinician may recommend a statin even if your cholesterol levels are not high. This will be because your QRISK assessment calculates you should take a statin. QRISK is an algorithm which calculates an individual’s 10 year risk of having a heart attack or stroke. The assessment takes into account factors such as:
Statins can also be used to treat familial hypercholesterolaemia. Which is an inherited condition caused by a genetic fault that leads to high cholesterol levels, even in people who have a generally healthy lifestyle.
More information regarding statins is available at BHF – Statins and NHS – Statins
There are a number of different statins that can be prescribed and you may need to trial different statins to find one that suits you best. If you are sensitive to all statins alternative lipid-lowering medication can also be offered. For more information on statins visit Heart UK
There has been considerable negative press around statin medication but it is important that when declining any medication you make an informed decision. Please watch the video below and contact the surgery if you still wish to decline for this year. Once the practice have registered your decline we will contact you each year to ensure your decision remains the same.