8. Cardiovascular diseases: risk assessment and prevention

• Risk assessment
  • SCORE risk estimation system
    • Two separate systems for high-risk and low-risk European regions
    • Estimates the risk of fatal cardiovascular events in the next 10 years, based on
      • Gender
      • Age
      • Smoking
      • Systolic BP
      • Total cholesterol
    • Very important to learn!
    • SCORE for high-risk European countries
    • SCORE for low-risk European countries
  • Framingham risk scoring
    • Not used in Europe, not so important
    • Points for
      • Age
      • total cholesterol
      • HDL
      • Systolic BP
      • Smoking
    • Sum of points gives risk
• Prevention
  • Primordial – activities which reduce or remove risk factors
    • Improve public transport availability
    • Opportunities for recreational activities
    • Increased socioeconomic development
    • Smoke-free restaurants
  • Primary – reducing the population’s exposure to risk factors
    • Health education programs
    • Anti-smoking campaigns
    • Sports programs
    • Nutritional counselling
  • Secondary – screening
    • Regular check-ups
      • Cholesterol
      • Lipids
      • Glucose
  • Tertiary – prevention of recurrence and treatment of symptomatic patients
    • 5 – 7 x higher risk in those with previous CVD
• Recommended targets
  • Very high CV risk (SCORE > 10%)
    • LDL < 1,8 mM
  • High risk SCORE > 5%
    • LDL < 2,5 mM
  • Moderate risk
    • LDL < 3,0 mM