What is a cardiac risk calculator?
The calculator measures and analyzes cardiovascular health to predict the risk of developing atherosclerotic cardiovascular disease (ASCVD).
A person can then use this information for guidance on future potential problems and how to prevent them.
Different methods are available, but, as far as possible, use a calculator that a doctor recommends and that authorities on heart health have validated for scientific accuracy.
In this article, we examine the factors a cardiac risk calculator uses and why. We also look at the lifestyle measures a person can take and the medical support professionals can provide to help reduce the risk.
What is a cardiac risk calculator?
Assessing cardiovascular risk involves taking a number of measurements and calculating the percentage risk of heart problems.
A cardiac risk calculator takes data for an individual's predictors of disease, such as blood pressure, and compares the results with population-level statistics.
Based on this information, the calculator tries to predict their chances of ASCVD, and the person will find out their percentage risk of having heart and blood vessel problems.
This information can help the individual take measures to prevent cardiovascular health issues, if necessary.
If the risk is very low, no further screening or treatment is necessary. If the calculator shows a high risk, a health professional will discuss lifestyle adjustments and other measures that may prevent an adverse event.
People undergoing treatment for a cardiovascular condition will probably not use a calculator, as they are already managing their risks through treatment.
All cardiac risk calculators use biological factors that affect an individual's risk of developing problems in the arteries.
Three key factors are out of an individual's control when assessing for cardiac risk: Age, ethnicity, and sex. Other factors are modifiable.
For the final result, a cardiac risk calculator must consider the following data:
- lifestyle characteristics, such as smoking habits, alcohol consumption, and diet
- doctor's office measurements, including body mass index (BMI) and blood pressure
- laboratory test results, for example, cholesterol levels
Managing these modifiable risk factors can help prevent their development into a dangerous disease. As a result, an individual may be able to avoid some of the causes of atherosclerosis and heart disease.
Atherosclerosis refers to the narrowing of arteries due to the formation of plaque in the coronary arteries that supply the heart.
Preventing heart disease can also reduce the risk of other health problems. For example, atherosclerosis might cut off blood supply to the brain, triggering to a stroke.
Doctors recommend the regularity of the assessment based on the age of the patient. Older adults may require assessment as often as every 4 years.
The risk assessment guidelines are suitable for people between the ages of 20 and 79 years who do not yet have any outward signs of cardiovascular disease
The American College of Cardiology (ACC) and the American Heart Association (AHA) produced one example of a cardiac risk calculator. You can access it here.
All cardiac risk calculators do a similar job, but various options are available.
A person should select a calculator that is relevant to the population overall and the individual's state of health.
In the United States, for example, doctors might base heart prediction scores and prevention recommendations on guidance from experts across the ACC, AHA, and the American Stroke Association (ASA).
Another calculator is provided by the U.S. National Heart, Lung, and Blood Institute (NHLBI). It requires the same input, but ethnicity and genetic status do not feature as prominently. It may, therefore, not be sensitive to people from all ethnic backgrounds.
The JBS3 calculator, which people commonly use in the United Kingdom, also factors in a person's socioeconomic status, based on their residential location. Research shows that this, too, can impact cardiovascular risk.
After a cardiac risk assessment, the resulting score will suggest the percentage risk of experiencing a heart attack or stroke within an individual's lifetime and within the next 10 years.
The results also indicate whether lifestyle adjustments or other preventive steps are necessary to reduce cardiovascular risk.
Clogged arteries can result from an unhealthful diet, smoking, and a lack of exercise.
A health professional will explain the results to the patient and make recommendations.
A doctor may recommend that people with a low risk of cardiovascular disease continue with their current lifestyle or increase exercise levels slightly.
If the calculator shows some risk, the health worker may discuss treatment measures that people can implement in their own lives, such as tackling cholesterol levels in the diet, making an exercise plan, and quitting smoking.
Alternatively, the doctor may recommend following up with tests, specialist advice, and appropriate medical interventions.
Avoiding or quitting smoking is a key lifestyle measure for reducing cardiac risk.
Researchers who published results of a meta-analysis covering 141 cohort studies in BMJ in January 2018 concluded the following:
Smoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders.
In other words, when considering smoking and heart health, even one cigarette a day is too much.
Cholesterol levels in the blood are a major factor for increased cardiac risk.
A blood test can measure low-density lipoprotein (LDL), or "bad" cholesterol, high-density lipoprotein (HDL) or "good" cholesterol, and total cholesterol.
Consume more good cholesterol than bad, and keep overall cholesterol intake to a minimum.
Diet and exercise can help treat or prevent high cholesterol.
In the diet, limiting the consumption of fats, and especially saturated fats, can help an individual manage cholesterol levels.
Keep the intake of saturated fats to a minimum. These are the fats that occur in the following types of food:
- some meats
- dairy products
- baked goods
- deep-fried foods
- processed foods
Avoiding the trans fats present in some fried and processed foods is also important for heart health.
Medical professionals might offer people who already have cardiovascular disease, or who have a higher risk due to other conditions, such as diabetes, a cholesterol-reducing drug therapy, such as statins.
People who have not been able to reduce their cholesterol levels through lifestyle measures alone may also use statins to do so.
Click here to read about tracking cholesterol levels.
Managing blood pressure
Blood pressure is high if it reaches 130/80 mm Hg or above, according to the AHA's 2017 guidelines.
Tips for controlling high blood pressure include:
- controlling body weight
- managing stress
- dietary measures, such as reducing the intake of sodium
- limiting alcohol
Medications may be necessary to help some people control high blood pressure.
Controlling body weight
Different methods are available for measuring a healthy weight.
BMI offers a useful guideline, but fat distribution may be a better indicator of cardiovascular risk.
People who carry excess weight around their abdomen or waist may face a higher risk of heart disease than those whose weight sits around their hips.
Use this calculator to work out your BMI.
Some recommendations from the AHA for losing weight include:
- getting at least 2 hours and 30 minutes of moderate exercise every week
- learning how to eat healthfully when dining out
- becoming familiar with nutrition labels and what they mean
The DASH diet, which includes plenty of fresh fruit and vegetables, can help you control your blood pressure, cholesterol levels, and, with adjusted calorie targets, your weight.