You don't have a time machine, but you do have the ability to calculate your 10-year heart disease risk. Decades of research have shown how heart disease risk factors such as high cholesterol and lifestyle choices like smoking cigarettes add up.
The National Cholesterol Education Program (NCEP) has published a set of guidelines intended to help patients and doctors accurately predict heart disease risk. The greater your risk for heart disease within 10 years, the more aggressively you should approach prevention. For example, according to the guidelines, people diagnosed with coronary heart disease or an equivalent health condition, such as diabetes, face a more than 20 percent risk of a heart event within 10 years. Add other risk factors, such as high cholesterol, advanced age, cigarette smoking, and a family history of early heart disease, and your total risk notches up.
The NCEP guidelines include charts that enable you to calculate a very specific risk score, based on your risk factors, age, and gender. For example, a 57-year-old man could use the charts to find out that he gets 7 points for age, 5 points for cholesterol over 280, 3 points for smoking cigarettes, and 1 point for his slightly high but treated high blood pressure. Adding them all together, he has 16 points, or a 25 percent risk of a heart disease event within ten years.
The same approach is applied to diet — using the diet appendix in the guidelines, you can give yourself points for the types of foods you eat regularly to find out whether you are eating a heart-healthy diet.
Once you have a good idea of your heart disease risk, you can make an informed decision about the steps you want to take to reduce that risk.
“We want to match the intensity of treatment that we recommend to any patient with that patient’s level of risk,” said Daniel Levy, MD, director of the Framingham Heart Study and professor of medicine at Boston University in Boston. This is because the changes you may have to make all come with some degree of risk and burden.
Calculate Your Heart Disease Risk
This is the information you need to calculate your risk:
- Your age. As you get older, your overall increase for heart disease and heart attack goes up. For men this means being over age 45 and for women, over 55.
- Cholesterol. You need to know your total cholesterol, plus the “bad” low-density lipoprotein (LDL) cholesterol and the “good” high-density lipoprotein (HDL) cholesterol in your blood. If your LDL is too high or your HDL is too low (less than 40 mg/dL), you are at risk. Get a blood test to find out what your cholesterol levels are if you do not already know.
- Blood pressure. It should be 140/90 or lower. If you are taking medication to control blood pressure, you are still considered to be at risk even if your blood pressure is under control.
- Chronic diseases. There are other health conditions, such as diabetes, that are closely tied to heart disease risk.
- Family history. If you have close male relatives who had heart disease before age 55 or close female relatives with heart disease before age 65, you are at increased risk. However, Levy points out that many people do not know all the details of their family’s history with heart disease. Make the best guess you can if you don’t have someone to ask.
- Smoking cigarettes. Bad news for people who are smokers — this is a strong independent risk factor for heart disease.
Of course, calculating heart disease risk is a more complex than simply using an online calculator, so check with your doctor to make sure you're taking all the steps you need to take.