It is Possible to Know Your Risk of Getting Heart Disease in Advance
Risk factors generally considered in the scores are age, gender, blood pressure, cholesterol levels, diabetes, and smoking.
The leading cause of death and loss of employment in developed countries in heart diseasesIt is possible to calculate the risk of catching a disease in advance and take precautions before clinical symptoms appear. In recent years, preventive medicine, that is, taking precautions before the disease develops and preventing the disease from occurring, has taken precedence over curative medicine. A wide variety of risk scores have been developed for different societies based on heart disease risk factors. Today, in practice, the patient is evaluated according to the appropriate risk scoring system and lifestyle changes and, if necessary, drug therapy are initiated.
There are various risk scores applied to patient groups in different societies (white race, black race, etc.) in published studies. The most well-known of these are; SCORE, Framingham (FRS), global cardiovascular risk, ASSIGN, QRISK, Reynolds. The risk factors generally examined in the scores are; age, gender, blood pressure, cholesterol levels, diabetes, smoking.
Although there are not many studies on which one is more suitable for Turkish society, according to our current knowledge SCORE has higher sensitivity (detecting those with disease) and negative predictive value (detecting those without disease) It can be preferred because it has. It is a scoring system developed as a result of a reliable and large number of patients (more than 3 million) study conducted by the European Society of Cardiology and can be used by different countries as the “HeartScore” program. HeartScore scoring is a web-based application. It is currently available in English. Age, smoking habits, blood pressure and cholesterol or total cholesterol/HDL ratioaccording to risk of cardiovascular deathni. The HeartScore program shows the absolute risk of cardiovascular disease in a bar chart and the contribution of preventable risk factors to the total risk in a pie chart. It is also possible to modify the tables according to national data. This risk score can be applied to all patients, male and female, aged 40-65. However, it is not recommended for use in patients with existing heart disease and diabetes. These patients are considered “high risk patients” regardless of the score and maximum treatment should be started. For other patient groups, it is recommended to start treatment if the 10-year heart disease risk exceeds 5%.
According to the results obtained from the studies, it is possible to take precautions against heart diseases to a certain extent with risk scores. However, the success in predicting the disease is not 100%. In the studies conducted in recent years, new risk factors for heart disease (lipoproteins, lipoprotein remnants, lipoprotein a, LDL, HDL subgroups, apolipoproteins B/AI, total cholesterol/HDL cholesterol, homocysteine, thrombogenic/hemostatic factors, inflammatory markers) have been defined. These risk factors are not included in the current scores. Although it has some limitations, the use of a risk score such as HeartScore in clinical use; both helps to take the necessary precautions before the disease occurs and motivates the patient to make lifestyle changes.
