Two commonly used scoring systems to estimate the 10
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Health Science
Date
Dec 6, 2023
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Two commonly used scoring systems to estimate the 10-year cardiovascular disease (CVD) risk
are:
1. Framingham Risk Score: This is based on data from the Framingham Heart Study and includes
factors such as age, gender, total cholesterol, HDL cholesterol, blood pressure, and smoking
status. This patient’s risk assessment is 29.4% putting him as a high-risk patient with a vascular
age
of
more
than
80
years
old.
2. ACC/AHA Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator: Developed by
the American College of Cardiology (ACC) and the American Heart Association (AHA), this
tool considers factors such as age, gender, race, total cholesterol, HDL cholesterol, blood
pressure, diabetes, and smoking to estimate the 10-year risk of atherosclerotic cardiovascular
events. His score with this calculator would be 13.4% and the optimal risk is 5.1%.
Both scoring systems are widely used by healthcare professionals to assess an individual's risk
and guide decisions regarding lifestyle changes and potential medical interventions (Petruzzo et
al.,
2021).
In addition to the factors used in scoring systems, healthcare professionals may consider the
following elements for a more comprehensive assessment of cardiac risk:
Physical
Exam
Findings:
1. Body Mass Index (BMI): Assessing weight in relation to height can provide information about
obesity,
a
risk
factor
for
cardiovascular
disease.
2. Waist Circumference: Central obesity, indicated by increased waist circumference, is
associated
with
a
higher
risk
of
cardiovascular
events.
3. Physical Activity Level: Sedentary lifestyles contribute to cardiovascular risk, so
understanding
a
patient's
activity
level
is
important.
Patient's
History:
1. Family History: A family history of early cardiovascular disease may increase risk.
2. Medical History: Conditions like diabetes and chronic kidney disease are important
considerations.
3. Dietary Habits: Unhealthy dietary patterns can contribute to cardiovascular risk.
Additional
Laboratory
Findings:
1. Blood Glucose Levels: Elevated levels may indicate diabetes or impaired glucose metabolism,
increasing
cardiovascular
risk.
2. High Sensitivity C-Reactive Protein (hs-CRP): Elevated levels may indicate inflammation,
which
is
associated
with
cardiovascular
risk.
3. Lipid Profile: Beyond total cholesterol and HDL, assessing LDL cholesterol and triglycerides
provides
a
more
detailed
picture
of
lipid-related
risk.
These additional factors contribute to a more nuanced understanding of an individual's
cardiovascular risk and help tailor interventions and recommendations accordingly. It's essential
for healthcare providers to consider a holistic approach when evaluating cardiac risk.
In this patient, several risk factors are noted: lack of physical activity, high BMI which indicates
obesity, has a diagnosis of hypertension, drinking alcohol daily, his father died of a heart attack,
in addition to blood laboratories with abnormal cholesterol findings (
Widanagamage et al., 2023).
Recommendations to decrease the risk of cardiovascular disease (CVD):
1.
Healthy
Diet:
- Emphasize a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats.
- Limit intake of saturated fats, trans fats, cholesterol, and sodium.
- Consider the DASH (Dietary Approaches to Stop Hypertension) eating plan.
2.
Regular
Physical
Activity:
- Engage in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of
vigorous-intensity
exercise
per
week.
-
Include
strength
training
exercises
at
least
twice
a
week.
3.
Maintain
a
Healthy
Weight:
- Achieve and maintain a body mass index (BMI) within the recommended range.
-
Focus
on
gradual,
sustainable
weight
loss
if
overweight.
4.
Quit
Smoking:
-
If
the
patient
smokes,
strongly
encourage
smoking
cessation.
-
Provide
support
and
resources
for
smoking
cessation
programs.
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5.
Limit
Alcohol
Intake:
- If the patient consumes alcohol, advise moderation: up to one drink per day for women and
up
to
two
drinks
per
day
for
men.
6.
Manage
Stress:
- Encourage stress-reducing activities such as deep breathing, meditation, or yoga.
-
Promote
a
healthy
work-life
balance.
7.
Regular
Health
Check-ups:
- Schedule regular follow-up appointments for monitoring blood pressure, cholesterol levels,
and
overall
cardiovascular
health.
-
Adhere
to
prescribed
medications
and
treatment
plans.
8.
Medication
Adherence:
- If prescribed medications (such as statins or antihypertensives), emphasize the importance of
consistent
adherence.
It's important to tailor these recommendations to the individual's specific health profile and
encourage ongoing communication with healthcare providers for personalized guidance (Bickley,
2022).
References
Bickley, L. S. (2022). Bate's Guide to Physical Examination and History Taking (13th ed.). Wolters
Kluwer
Petruzzo, M., Reia, A., Maniscalco, G. T., Luiso, F., Lanzillo, R., Russo, C. V., ... & Moccia, M. (2021). The
Framingham cardiovascular risk score and 5
‐
year progression of multiple sclerosis.
European
Journal of Neurology
,
28
(3), 893-900.
Widanagamage, R., Silva, K. H. M., Ayeshmantha, H. A. C., Kariyawasam, K. U. G. D. M., & Wijesinghe,
R. A. N. K. (2023). Correlation of Atherogenic Index of Plasma and Atherogenic Coefficient with
Cardiovascular Disease Risk assessed by ASCVD Risk Calculator.
Journal of Health Sciences
and Innovative Research
,
4
(01).