Assessing your risk of heart disease and stroke

Understanding your health risk puts you in a better position to decide which elements of your daily life you might need to change to give you the best protection against heart disease and strokes. Here's what you need to know about assessing your risk of heart disease and stroke.

As preventive medicine gains ever more prominence in health services, doctors are taking a more proactive role in patient care. For example, if you are over 40, your doctor may invite you to have a "heart health check" to determine your risk of developing cardiovascular disease in the future.

The scoring system doctors generally employ to assess a patient's risk takes account of age, gender, family history, systolic blood pressure, blood cholesterol levels and whether he or she smokes.

As far as cholesterol is concerned, what matters is the ratio between the total cholesterol and "good" HDL cholesterol; the higher the proportion of HDL, the better.

Once this data is collected, a computer program is used to analyze it and to estimate the likelihood of a patient experiencing a heart attack or stroke within the next 10 years.

When deciding whether to advise drug treatment or make a referral to a cardiologist, a doctor will also note whether the patient already has signs of cardiovascular disease — especially angina — or peripheral arterial disease, or a family history of heart attacks or strokes.

The doctor will look at linked problems such as diabetes or obesity and measure a patient's weight and height. The result gained from these measurements is called body mass index, or BMI.

The formula that doctors use to estimate risk is complicated, but there are online calculators where you can feed in your own figures and work out your risk.

For this quick DIY solution, you'll need to know your blood pressure and cholesterol levels (both total cholesterol and HDL cholesterol) but, as both are important health indicators, it is worth asking your doctor to check them, especially if you are over the age of 40.

Also, if you decide to test your heart disease and stroke risk on your own, take the results with a grain of salt and bring any concerns you have to your doctor.

Risk factors tend to be interlinked and can exacerbate each other, so the more risk factors you have, the higher your overall level of risk. In fact, cardiovascular risk resembles an intricate spider's web: obesity, high blood pressure and diabetes all increase your risk.

Obesity combined with a high intake of salt or excessive alcohol consumption also raises the risk of high blood pressure.

Also, a poor diet can contribute to obesity, diabetes, high blood pressure and high cholesterol — all of which feed into your overall risk, as well.

As per stress, it increases your risk both directly and indirectly. Stress has this direct and indirect effect because higher stress levels are related to increases in blood pressure.

Age is also a factor. The older a person is, the more susceptible he or she is to high blood pressure that stress at work can cause.

Habits play a role in your risk level too. The worst among bad habits, though, is smoking, which is specifically highlighted in the risk-prediction charts that medical staff use.

For example, if you're a man under 50 who is also a non-smoker with normal blood pressure and cholesterol levels, your chance of getting cardiovascular disease within the next 10 years is low (less than 10 per cent). But, change just one element — add a smoking habit, for example — and your risk of heart attacks or strokes rises to between 10 and 20 per cent.

Similarly, if you are a woman aged between 50 and 59, smoking increases your risk dramatically — pushing it as high as 30 per cent if you also have high blood pressure and a high level of "bad" LDL cholesterol in your blood.

So try to find out what your greatest risk factor for heart disease or heart attacks is — obesity, high blood pressure, diet, cholesterol, diabetes or stress — and ask your doctor how to improve in that area. Then, if you put your doctor's advice into practice, you should be able to reduce your risk of heart attack and heart disease.