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Low Risk Example
Read through the following 3 cases to see various ways you might use the risk assessment tool in different situations.
Low Risk Case 2
Linda is a female patient aged 51 with 114/79 mm Hg blood pressure, total serum cholesterol of 7.0 mmol/L, HDL cholesterol of 1.0 mmol/L with no history of diabetes, familial hypercholesterolaemia, family CVD or smoking. She is very overweight with a BMI of 32.
Feedback
The patient’s 5 year CVD risk is 4% in the low risk category so medication is not recommended.
Patients may appear to be higher risk if they have one isolated risk factor but all other risk factors are low (e.g. an overweight younger woman with raised cholesterol but low blood pressure and no history of smoking/diabetes). Since age and sex are such strong predictors of CVD risk, this may be particularly the case for younger patients and women. Conducting an objective risk assessment is especially important in these cases if medication is being considered, as the benefit of medication may be very low if the baseline absolute risk is low. However, if there is a very elevated risk factor (7.5 for total cholesterol or 180 for systolic blood pressure) then the risk is considered high and you don’t need to do an absolute risk assessment. The calculator will flag when these thresholds are reached.
There is the possibility of over estimating I think the risk of some people who are a little bit younger…and then there is the potential of prescribing certain medications that particularly statins which may not really benefit them all that much from an absolute perspective
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Peer discussion
Low Risk Case 2
Linda is a female patient aged 51 with 114/79 mm Hg blood pressure, total serum cholesterol of 7.0 mmol/L, HDL cholesterol of 1.0 mmol/L with no history of diabetes, familial hypercholesterolaemia, family CVD or smoking. She is very overweight with a BMI of 32.
Feedback
The patient’s 5 year CVD risk is 4% in the low risk category so medication is not recommended.
Patients may appear to be higher risk if they have one isolated risk factor but all other risk factors are low (e.g. an overweight younger woman with raised cholesterol but low blood pressure and no history of smoking/diabetes). Since age and sex are such strong predictors of CVD risk, this may be particularly the case for younger patients and women. Conducting an objective risk assessment is especially important in these cases if medication is being considered, as the benefit of medication may be very low if the baseline absolute risk is low. However, if there is a very elevated risk factor (7.5 for total cholesterol or 180 for systolic blood pressure) then the risk is considered high and you don’t need to do an absolute risk assessment. The calculator will flag when these thresholds are reached.