As you might be aware, elevated cholesterol can increase your risk of developing cardiovascular diseases (CVD), such as heart attacks, strokes, and peripheral vascular disease. However, cholesterol is just one of many risk factors for cardiovascular disease. By using your medical record information, we can apply the QRISK2 tool to determine the likelihood of you having a stroke or heart attack within the next 10 years. A higher score indicates a greater risk, and having more risk factors further elevates this risk.
Other factors that contribute to CVD risk include:
- Age, gender, and ethnicity
- High blood pressure, cholesterol levels, and body mass index (a measure of height and weight)
- Smoking and alcohol consumption
- Medical conditions like diabetes, rheumatoid arthritis, and chronic kidney disease
- A strong family history of heart disease, particularly in relatives under 60 years old
What is meant by ‘risk’?
Risk refers to the probability of a particular event occurring. It’s essential to recognize that your risk of developing CVD is never zero, and it naturally increases with age, irrespective of other risk factors. Your QRISK score will indicate whether your risk of developing CVD in the next 10 years is low, moderate, or high.
Low Risk – QRISK score below 10%: indicating less than a one in ten chance of having a stroke or heart attack within 10 years.
Moderate Risk – QRISK score between 10% and 20%: signifying a one to two in ten chance of
experiencing a stroke or heart attack in the next 10 years.
High Risk – QRISK score above 20%: suggesting at least a two in ten chance of developing CVD within the next decade.
Can I lower my risk?
- According to the latest guidelines from NICE (National Institute for Health and Care Excellence), individuals with a QRISK score of more than 10% (moderate risk) should be oXered help to reduce their risk. This assistance includes:
- Lifestyle Changes: Adopting healthier habits such as eating a balanced diet, exercising regularly, quitting smoking, and reducing alcohol intake. If these changes alone are not effective or if your risk remains above 10%, further measures may be considered.
- Medication: For those whose risk is still high despite making lifestyle changes, or for those who have a QRISK score above 10%, starting medication to lower cholesterol (such as statins) may be recommended.
Lifestyle changes
You may have observed that some risk factors are within your control (such as smoking status, weight, and blood pressure), while others are not (like age and gender). To reduce your risk, consider the following lifestyle changes:
- Quit Smoking: Transition to vaping if necessary, as it is less harmful.
- Eat a Balanced Diet: aim for foods low in fat, sugar, and salt, and for 5 fruits and vegetables each day.
- Reduce Alcohol Intake: less than 14 units per week for both men and women.
- Maintain a Healthy Weight: aim for a BMI between 20-25. Take steps to lose weight if needed.
- Medications for Blood Pressure: to be considered if necessary.
You will probably benefit from lifestyle changes regardless of your risk level. However, we can recheck your cholesterol levels in 6-12 months, along with measuring your weight, height, and blood pressure to recalculate your QRISK score. If your score remains the same or increases, a GP or nurse can discuss whether you should take a statin.
For more information on lifestyle changes, visit the NHS website for cholesterol or the sites listed below.
For more information on local groups, centres, amenities to help with lifestyle changes, see the Local Lifestyle Wellbeing Resources document.
Statins
Statins are a class of medications that help lower cholesterol, potentially reducing your risk of heart attack and stroke by up to 25%. They are intended to be taken nightly and are generally safe, though, like all medications, they can have side effects.
For more details on statins, visit the NHS statins website or the other sites listed below. If you would like to discuss the possibility of taking a statin, please schedule an appointment with your nurse or GP.