Let’s talk about risk and lifestyle change
5 Sep 2018 02:59 PM
Bloig posted by: Dr Samuel Finnikin, GP, Sutton Coldfield and clinical research fellow, University of Birmingham, 05 September 2018.
Dr Finnikin explains how he approaches patients about cardiovascular risk and changes to lifestyle
Not a week goes by without me seeing a patient who has recently had a blood test and is anxious to know what their cholesterol level is.
The answer to that question is just a number, and it’s not the most important question to ask. The important questions are: what is my risk of cardiovascular disease - heart attack and stroke? And, how can I reduce the risks?
As a GP I use the QRISK2 calculator to estimate the risk of heart attacks or strokes to answer the first question. The answer to the second question depends on this risk score. If it is under 10%, we discuss lifestyle changes, and if it is over 10%, then we have two things to discuss: lifestyle changes and statins.
When it comes to reducing the risk of cardiovascular disease, the most important part of the management plan are the changes in lifestyle that can be made.
Stopping smoking, being active and eating and drinking healthily are the priority. These lifestyle factors are the most important things patients can change to reduce their risk of cardiovascular disease.
Everyone is different though. Some feel able to make changes, whilst others struggle to adjust to a new lifestyle to benefit their health. I can just advise, guide and encourage.
My research, which was supported by NICE, showed that not everyone started on a statin had a risk assessment documented in their medical record. This could mean patients didn’t know their cardiovascular risk when they were offered a statin.
For those patients who may benefit from taking a statin we can discuss the pros and cons of medication. But this is not an either or option. Taking a statin may provide benefit by reducing cholesterol but it doesn’t mean you don’t have to think about lifestyle change. Lifestyle change is the focus.
As GP, I would strongly argue that knowing your cardiovascular risk has become more important than knowing your cholesterol.
You can get an estimate of your own cardiovascular risk and more advice on what you can do about it through the NHS health check website.