n Information for patients
What is the QRISK® CVD score?
n QRISK®2 is a well established cardiovascular disease (CVD) risk score, in use across the NHS since 2009, which is designed to identify people at high risk of developing CVD who need to be recalled and assessed in more detail to reduce their risk of developing CVD.
n The QRISK®2 score estimates the risk of a person developing CVD over the next 10 years.
n QRISK®2 has been specifically developed by doctors and academics for use in the UK.
n The original research underpinning QRISK® was published in July 2007 in the British Medical Journal and in January 2008 inHeart journal. The original research underpinning version 2 ofQRISK® (QRISK®2) has been published in the British Medical Journal in June 2008.
n The research was done using the QResearch anonymised medical research database which consists of the electronic health records of over 10 million patients registered with 550 general practices using the EMIS clinical computer system of whom 2 million contributed to the QRisk dataset.
n All medical decisions relating to the QRISK®2 score need to be taken by a patient in consultation with their doctor. The authors, University of Nottingham, ClinRisk and EMIS accept no responsibility for clinical use or misuse of the score.
What is cardiovascular disease?
n Cardiovascular disease is a term used by doctors to refer to a collection of diseases such as:
o Transient ischaemic attack
o Myocardial infarction or heart attacks
What does 10 year risk of cardiovascular disease mean and why is it important?
n 10 year risk of cardiovascular disease means the risk of someone developing cardiovascular disease over the next ten years.
n If someone has a 10 year QRISK®2 score of 20% then in a crowd of 100 people like them, on average 20 people would get cardiovascular disease over the next 10 years. Or put another way, they have a ‘one in five’ chance of getting cardiovascular disease over the next 10 years.
n If you have a QRISK®2 score of 20% or more then you are considered to be at high risk of developing cardiovascular disease and need to have advice or treatment to reduce your risk. You should contact your doctor for further advice.
How can I work out my risk?
n You can use the QRISK®2 web calculator to estimate your risk.
n Note though that this is just an estimate and that if you do not know some of the information needed for the calculator (like your blood pressure) then it will substitute population average values for someone of your age and sex so the result is just a guide.
n If you are concerned about estimated risk then you can see a doctor or nurse for a full risk assessment.
n Your doctor will have a way of identifying who needs to be assessed based on information already present in your electronic health record and may contact you if you need a review.
What is body mass index and how is it measured?
n Body mass index is a number calculated from your height and weight.
n It is the weight in kilograms divided by the height in metres squared.
n Conventionally a person is considered to be obese if they have a body mass index over 30 kg/m2
What does ‘family history of premature coronary heart disease in a first degree relative mean’?
n You have a positive family history if you have a mother, father, brother or sister who has had a heart attack or ‘angina’ under the age of 60.
n If you have a positive family history it will give you an increased risk so it is even more important that you try to have a healthy lifestyle ie don’t smoke or aren’t overweight, do exercise etc.
Which people can have a QRISK®cardiovascular score calculated?
n You can use QRISK®2 if you are aged between 30 and 84 years unless you:
o Have had a heart attack, angina or stroke, heart failure or peripheral vascular disease (poor circulation)
o Are currently prescribed medicines to lower your cholesterol (statins)
I live in the UK and I am from a black or ethnic group. Can I use the QRISK®calculator?
n Yes you can use QRISK®2 calculator which now includes self assigned ethnicity
Why does the score need a postcode?
n Cardiovascular risk varies according to where people live and the score takes account of this for us.
I am over 84 years, why isn’t QRISK®suitable for someone of my age?
n Most people over the age of 84 years have a risk score of more than 20% and so the QRISK®2 score isn’t terribly useful at identifying high risk patients once they get to this age.
My score is greater than 20% using the web calculator.
What things can I do myself to reduce my chances of getting heart disease?
n If your QRISK®2 is more than 20% then you should speak to your doctor.
n You can do things yourself to lower your risk.
n The biggest thing you can do is to stop smoking if you smoke (your doctor can help you with this).
n Take regular exercise (need more detail).
n Try to Lose weight if you are overweight (body mass index is > 25kg/m2).
n Your doctor might advise you to take medication to lower your blood pressure or lower your cholesterol levels.
My score is between 10% and 20%, what should I do?
n You risk is below the threshold for needing medical treatment but you can still help lower your risk by doing the things above.
n Your score will rise as you get older so you could measure it again in a couple of years time to see how it is getting on.
n If you are concerned and want to discuss it or get some help to reduce your risk factors, then make an appointment to see your doctor.
I am on blood pressure treatment and I notice that my risk is higher than it would be had I not been taking blood pressure treatment. Why is this?
n Blood pressure treatment lowers your blood pressure and reduces your risk of heart disease and stroke.
n The fact that you are taking blood pressure treatment means that you have already been identified by your doctor as someone needing treatment which automatically puts you in a higher risk group.
n The treatment itself isn’t increasing your risk but is acting as a marker for the fact that your underlying risk is higher.
I am already taking statins given to me by my doctor. Should I see what my QRISK® score is?
n If you are already on statins then your doctor has already assessed your risk and decided to treat you so you don’t need to do it again.
n You do need to keep your appointments with your GP and keep taking the treatment you have been given.