Are you at risk for a heart disease? By becoming aware of risk factors (characteristics and habits you have) you can begin to modify your behaviors to decrease your risk of heart disease. There are some factors you can’t control, but some you can and should. Consult your physician or health care provider to get a plan that is safe and effective for you.
What is a cardiac risk assessment?
This is a group of tests and health factors that have been proven to indicate your chance of having a coronary event. They have been refined to indicate the degree of risk: slight, moderate, or high.
What is included in a cardiac risk assessment?
Perhaps the most important indicators for cardiac risk are those of your personal health history. Age, hereditary factors, weight, smoking, blood pressure, exercise history and diabetes are all important in determining your risk. The lipid profile is the most important blood test for risk assessment. There are other tests, non-invasive and invasive, which may be used in cardiac risk assessment. Non-invasive tests may include an EKG stress test, thallium stress test, EKG, CT scan, and echocardiogram. Invasive tests include an arteriogram and cardiac catheterization.
How is the lipid profile used?
The lipid profile measures cholesterol, triglycerides,
- Cholesterol <200 mg/dl (5.18 mmol/L)
- Triglycerides <150 mg/dL (1.70 mmol/L)
*optimal; levels will depend on the number and type of risk factors present and whether testing is being used in primary or secondary intervention
If any or all of your results are significantly outside these ranges, your risk of a cardiac event is increased. If they are only slightly outside the desirable level, diet, exercise, and/or medication may be sufficient to reduce the abnormal levels, thereby reducing the risk.
What other tests are used to assess cardiac risk?
Another test gaining importance is serum homocysteine. Homocysteine is an amino acid that comes from the normal breakdown of proteins in the body and appears to be a better test than cholesterol for predicting heart disease, stroke, and reduced blood flow to the hands and feet. Lipoprotein A, Lp (a), is a lipoprotein consisting of an
How is treatment determined?
Treatment will be based on many factors – including the results of the above tests and your family and personal medical and lifestyle history.
Is there anything else I should know?
Eating a healthy diet and exercising are important in reducing blood pressure, cholesterol and triglycerides. There are also drugs (known as statins) that have been effective in lipid management. There are some forms of elevated lipids that are hereditary and cannot always be lowered sufficiently by diet and exercise. This type of elevation usually requires treatment with lipid-lowering drugs.
FAQ’s
1. Are some people more at risk for a heart attack than others?
Those who are overweight, smoke, have high blood pressure or diabetes, abnormal risk test results, and those with a family history of heart disease are at greater risk.
2. Are there home test kits for determining if I am at risk for a heart attack?
No. The diagnosis is based on the results of any or all of the tests mentioned. The overall assessment requires special equipment and interpretation by a trained professional.
Resources: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) JAMA (2001) 285:2486-2497.
Clinical Chemistry: Theory, Analysis, Correlation. 3rd Edition. Lawrence A. Kaplan and Amadeo J. Pesce,
Clinical Chemistry: Principles, Procedures, Correlations. Micheal L. Bishop, Janet L. Duben-Engelkirk, Edward P. fody, Lipincott Williams & Wilkins, 4th Edition.
CARDIAC HEALTH RISK ASSESSMENT
The following factors may increase your risk for cardiovascular disease. Answer YES to any question that applies to you.
If you have two or more YES answers, see your primary care physician for a complete assessment. This quiz is not a substitute for medical advice or treatment.
Your
_____ You are a man over 45 years of age
_____ You are a woman over 55 years of age, OR you have passed menopause OR had your ovaries removed and are not taking estrogen
Your FAMILY HISTORY may increase your risk if…
_____ Your father or brother had a heart attack before age 55 OR your mother or sister had one before age 65
Cigarette and tobacco SMOKE increases your risk if…
_____ You smoke, or live or work with people who smoke every day
Your total CHOLESTEROL and
_____ Your total cholesterol levels is 240 mg/dL or higher
_____ Your
_____ You don’t know your total cholesterol or
Your BLOOD PRESSURE may increase your risk if…
_____ Your blood pressure is 140/90 mm HG or higher OR you’ve been told that your blood pressure is too high
_____ You don’t know your blood pressure readings
PHYSICAL INACTIVITY may increase your risk if…
_____ You get less than a total of 30 minutes of physical activity on most days
Excess BODY WEIGHT may increase your risk if…
_____ You are 20 pounds or more overweight for your height and build
DIABETES increases your risk if…
_____ You have diabetes OR a fasting blood sugar of 126 mg/dL (or higher) OR you need medication to control your blood sugar
