What is a cardiac risk assessment?
This is a group of tests and health facts that are used to assess your chance of having a heart attack.
What is included in a cardiac risk assessment?
There are two types of risk factors, those you can’t modify and those you can do something about. The Heart Foundation lists the risks below:
Non-modifiable risk factors
- increasing age
- having family history of heart disease
Modifiable risk factors
- smoking - both active smoking and being exposed to second-hand smoke
- high blood cholesterol - may be improved through exercise in combination with a healthy diet
- high blood pressure
- being physically inactive
- being overweight
- depression, social isolation and lack of quality support
For more information from the Heart Foundation on each of these modifiable risk factors click on one of the headings.
Australian guidelines now recommend that your “absolute risk” be measured. This is done by taking the factors listed below into account and using a risk calculator to assess your risk of developing cardiovascular disease over the next five years.
The factors are:
- your blood pressure
- cholesterol level
- whether or not you smoke
- have diabetes
- have chronic kidney disease
- have particular abnormalities on your ECG
- have a family history of CVD or high cholesterol
This is explained further in the National Heart Foundation publication “Know your heart and stroke risk” and an online risk calculator can be found here.
What other tests are used to assess cardiac risk?
Checking for diabetes by measuring fasting blood glucose, an HBA1c level or performing a glucose tolerance test is often required. Early identification of chronic kidney disease is also important as this is a risk factor. Other blood tests that may be used in special circumstances to assess your risk of heart disease include homocysteine (an amino acid that comes from the normal breakdown of proteins in the body), lipoprotein a (Lp(a)), and high-sensitivity C-reactive protein (hsCRP). Raised levels of any of these may indicate increased risk of having a heart attack and allow preventative measures to be taken, for example, by changes to diet and exercise habits.
How is treatment determined?
Treatment will be based on many factors – including the results of the above tests, your age and gender, and your family and personal medical history.
Is there anything else I should know?
Eating a healthy diet and exercising are important in reducing blood pressure, cholesterol and triglycerides. Smoking increases the risk of heart disease by 2 to 3 times and thus avoiding or stopping smoking is very important. There are also drugs (known as statins) that are effective in lowering cholesterol. There are some forms of raised cholesterol or triglycerides that are genetically inherited and cannot always be lowered sufficiently by diet and exercise. These usually require treatment with lipid-lowering drugs such as statins as well as diet and exercise.
Frequently Asked Questions (FAQs)
- Are some people more at risk for a heart attack than others?
Yes. For most Australians being aged over 45 is a risk factor but for Aboriginal and Torres Strait islanders incresed risk starts at age 35. 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.
- Are there home test kits for determining if I am at risk for a heart attack?
Tests for cholesterol are available but since this is only one risk factor, having an absolute risk assessment performed by your own doctor is much more useful. Once a risk score has been calculated home monitoring of some risk factors in close consultation with your GP may sometimes be used.