Heart attack and stroke – calculating your risk score

About heart attack and stroke#

Heart and blood vessel disease belongs to the group of conditions known as cardiovascular disease, and coronary heart disease is the main cause of heart attacks. It is one of the leading causes of death.

Some people do not realise they are at risk, because the main risk factors can be silent. For example, you may have high cholesterol or high blood pressure without any symptoms. High cholesterol and high blood pressure are major risk factors for heart attack and stroke, along with other factors you can change, such as physical inactivity and a poor diet.

A doctor can estimate your risk of having a heart attack or stroke over the next 5 years. This figure is called your cardiovascular disease risk score, and knowing it helps you and your doctor decide what to do to protect your heart.

What a heart health check involves#

A heart health check is a short appointment with your doctor for people who have not already had a heart attack or stroke. As part of it, your doctor will usually:

• ask about your lifestyle, including your diet, physical activity, and whether you smoke or drink alcohol
• ask about your medical and family history of heart disease
• check your blood pressure, cholesterol and blood sugar levels

Your doctor then uses this information to calculate your risk score and to make decisions with you about the best ways to improve your heart health. This can include lifestyle changes and, in some cases, medicines to manage blood pressure and cholesterol.

Risk factors used to calculate your score#

Your doctor weighs both factors you can change and factors you cannot.

Factors you can change include:

• tobacco smoking
• a poor diet
• physical inactivity
• being overweight or obese
• alcohol intake
• high cholesterol
• high blood pressure (hypertension)
• type 2 diabetes
• depression, anxiety and social isolation

Factors you cannot change include:

• your age
• your sex, and whether you are post-menopausal
• a premature family history of heart disease (an immediate family member, such as a parent or sibling, who had a heart attack or stroke before the age of 65)

People from some populations are also at increased risk, so it is worth asking your doctor about checking for risk factors earlier in life.

What your risk score means#

After considering your risk factors, your doctor calculates a risk score, expressed as a percentage. This is the probability of you having a heart attack or stroke in the next 5 years, which places you at low, intermediate or high risk.

Some people who already have certain medical conditions are known to be at high risk and do not need a calculated score. Your doctor will tell you if this applies to you and advise what to do. Whatever your score, your doctor will recommend health or lifestyle changes, and in some cases medicines, to reduce your risk.

Making changes to improve your heart health#

No matter what your risk score is, there are changes that help:

• Stop smoking.
• Stay active. You may wish to join a formal health and exercise program; ask your doctor or a local community health service about a suitable option. Walking is a great, social way to stay active.
• Maintain a healthy weight.
• Look after your mental health.
• Drink less alcohol.

A heart-healthy eating pattern#

Aim for:

• plenty of vegetables, fruit and wholegrains
• a variety of protein-rich foods, especially fish and seafood, legumes (such as beans and lentils), nuts and seeds
• unflavoured milk, yoghurt and cheese; choose reduced-fat varieties if you have heart disease or high cholesterol
• healthy fats and oils, such as nuts, seeds, avocados, olives and their oils for cooking
• herbs and spices to flavour food instead of salt

Eggs and poultry can also be part of a heart-healthy pattern. If you eat red meat, choose lean cuts and limit it to one to three times per week.

Some online tools estimate your “heart age” and compare it with your actual age. If your estimated heart age is higher than your real age, your risk of a heart attack or stroke may be higher too, which can be a useful prompt to act.

Key points#

• Coronary heart disease is the main cause of heart attacks, and its risk factors can be present without any symptoms.
• A doctor can calculate your cardiovascular disease risk score, your chance of a heart attack or stroke over the next 5 years.
• The score combines risk factors you can change with those you cannot.
• Knowing your score helps you and your doctor take steps to reduce your risk.

Where to get help#