See also: Cholesterol and cardiovascular risk
The cardiovascular risk quantifies the probability of suffering a disease affecting the heart or blood vessels based on the presence or absence of certain predisposing factors.
Cardiovascular Risk Factors can traditionally be divided into
- non-modifiable factors (sex, age, familiarity)
- factors that can be corrected with correct lifestyles and / or pharmacological treatments.
The correctable risk factors include:
- insulin resistance and / or hyperinsulinemia
- diabetes mellitus
- smoking habit
- overweight, obesity, abdominal circumference> 102 cm in humans or> 88 cm in women
- early menopause
- LDL hypercholesterolemia
- HDL hypocholesterolemia
- MPV> 12 fl
- inadequate diet
- alcohol and drug abuse
- low level of education
- high values of fibrinogen and C-reactive protein in the blood
- antithrombin III deficiency.
High Cholesterol and Cardiovascular Risk
High cholesterol is undoubtedly an important cardiovascular risk factor, but its relevance in the genesis of these diseases - which we have seen to be multi-factorial etiology - has long been overestimated.
Today, the choice to undertake or not a specific drug therapy is not dictated by the overcoming of a particular value of total cholesterol, but by the overall assessment of the subject's cardiovascular risk.
The identification of people with medium and high cardiovascular risk makes it possible to take actions that can positively change the lifestyle and the other unfavorable but modifiable elements (sex and age cannot be corrected for obvious reasons).
Card of cardiovascular risk
Based on these elements, a few years ago the Higher Institute of Health (ISS) drew up the so-called Cardiovascular Risk Card. This is a series of tables and suggestions that allow you to calculate the risk of suffering a major cardiovascular event (heart attack and stroke), fatal or non-fatal, in the following 10 years, in subjects who have not already suffered one. Although this card has its limits (for example, it is useful only in primary prevention and excludes the population groups under 40 and over 70), it is a valid tool available to general practitioners.
To estimate the absolute cardiovascular risk in the following 10 years it is necessary to take into consideration six factors (sex, age, LDL cholesterol and the presence or absence of diabetes, hypertension and smoking habits).
Once the appropriate table has been identified based on gender, age and presence of diabetes and smoking habits, we search for the box corresponding to our cholesterol values (in mg / dL or in mmol / L) and systolic blood pressure (mmHg). The color of this box expresses the subject's cardiovascular risk according to the legend, and in particular the probability of incurring a major cardiovascular event in the following 10 years.
Click to enlarge and calculate the cardiovascular risk
Individual risk score
In addition to the cardio-vascular risk card, the Istituto Superiore di Sanità has issued an additional tool, called an individual risk score. This aid differs from the previous one in some features.
First of all, the risk assessment is not expressed in a categorical but timely manner (assigns the risk based on the score of a given parameter and not the interval to which it belongs). In addition to the risk factors considered in the paper, in addition, the score takes into account the value of HDL cholesterol and the prescription of antihypertensive drugs, demonstrating for this a greater accuracy in the global risk assessment. Finally, while the card considers people aged between 40 and 69, the five-year period of age 35-39 is also included in the calculation of the individual score.
For the personalized calculation of the cardiovascular risk score it is possible to request information from the attending physician or use the specific electronic form.
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