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How To Predict Dying From Heart Disease In The Next 10 Years

Dr. Anthony Close
July 1, 2019
Health Hub

Details

ASCVD means atherosclerotic cardiovascular disease, or in other words, heart disease.

ASCVD, or atherosclerotic cardiovascular disease, is caused by plaque buildup in arterial walls and refers to the following conditions:

•Another type of heart disease, Coronary heart diseases (CHD), such as myocardial infarction, angina, and coronary artery stenosis > 50%.

• Cerebrovascular disease, such as a transient ischemic attack, ischemic stroke, and carotid artery stenosis > 50%.

• Heart disease is caused by Peripheral artery disease, such as claudication.

• Aortic atherosclerotic disease, such as abdominal aortic aneurysm and descending thoracic aneurysm.

Primary prevention refers to the effort to prevent or delay the onset of ASCVD.

Secondary prevention is the effort to treat known, clinically significant ASCVD and prevent or delay the onset of disease manifestations.

Using a few simple tests we commonly get during routine testing - we can predict the likely hood of dying in the next 10 years.  Those four things are:

heart disease

Cardiovascular and heart disease awareness Lab Me at home health checks

RISK

The 10-year calculated heart disease ASCVD risk is a quantitative estimation of absolute risk based on data from representative population samples.
The 10-year risk estimate for "optimal risk factors" is represented by the following specific risk factor numbers for an individual of the same age, sex and race: Total cholesterol of ≤ 170 mg/dL, HDL-cholesterol of ≥ 50 mg/dL, untreated systolic blood pressure of ≤ 110 mm Hg, no diabetes history, and not a current smoker.
While the risk estimate is applied to individuals, it is based on group averages.
Just because two individuals have the same estimated risk does not mean that they will or will not have the same event of interest.
Example: If the 10-year ASCVD risk estimate is 10%, this indicates that among 100 patients with the entered risk factor profile, 10 would be expected to have a heart attack or stroke in the next 10 years.

Changing thresholds for high risk

There are many ways to define "high-risk" conditions. Some researchers look at what percentage of patients with a specific condition experience a fatal event. Others look at the years until a patient experiences a fatal event. Still, others look at the age at which a person has a fatal event.

We've chosen to use the high-risk threshold based on our research. Our research shows that a person is at high risk for developing a fatal event after experiencing certain conditions.

Using this approach, we could say that a person is considered at high risk for developing a deadly heart attack if they:

Have had a heart attack before (have survived)

Are over 65 years old

Have smoked cigarettes for 30+ years

Have high cholesterol

Have high blood pressure

Have a family history of premature coronary artery disease

Have a sedentary lifestyle

These criteria are called CHAID rules. They help us identify groups of individuals at higher risk of developing a fatal heart attack.

Other aspects of the SCORE risk charts

The SCORE risk charts are designed to be easy to understand and use. But don't take them too literally.

The chart will give you a general idea of your risk level. It doesn't tell you exactly when you'll develop a fatal event.

When you see your risk score, remember that it reflects your current health status. Your risk scores may change over time.

Your risk score also changes depending on whether you smoke, exercise regularly, eat healthy foods, etc. You can make some improvements to reduce your risk.

You can learn more about improving your risk by visiting our website.

What is the relationship between cholesterol and my risk of a heart attack?

Cholesterol plays a role in the development of heart disease, and atherosclerosis, a major cause of heart attacks. About 80% of people with heart disease have high LDL cholesterol levels. High LDL cholesterol increases your risk of a heart attack.

However, not everyone with high LDL cholesterol develops cardiovascular problems. For example, some people with genetic disorders like familial hypercholesterolemia have very high LDL cholesterol but do not develop heart disease.

Some people with high LDL cholesterol may benefit from statin drugs. Statins lower LDL cholesterol and decrease your risk of a heart problem. However, they don't work for everyone.

It's important to note that lowering LDL cholesterol does NOT guarantee you won't get a heart attack. People with low cholesterol often live long lives without getting heart disease

Various Types of Associated Heart diseases

Atherosclerosis is a thickening of the inner lining of large and medium-sized arteries. Arteriosclerosis affects the coronary arteries, carotid arteries, and peripheral arteries. Atherosclerosis reduces blood flow through these arteries and can lead to heart attacks, stroke, and limb amputation.

Heart failure is when the heart cannot pump enough blood to meet the body’s needs. It usually develops after a myocardial infarction (heart attack). Heart failure can also be caused by valvular disorders, congenital defects, infections, and hypertension.

Heart rhythm disturbances such as arrhythmias are abnormal heart rhythms that affect the timing of electrical impulses. These irregularities can cause irregular heartbeat, palpitations, fainting, and even death.

Congenital heart diseases are abnormalities of the heart's structure that are present at birth. Congenital heart disease can be divided into structural and functional conditions. Structural conditions include malformations of the chambers, valves, septa, and great vessels. Functional conditions include hypoplasia, hypertrophy, and dilation of the ventricles.

Congestive heart failure is a clinical syndrome that describes the inability of the heart to fill with or eject blood adequately. Congestive heart failure may occur due to an abnormality of the heart's right, left, or both sides. Causes of congestive heart failure include coronary artery disease, cardiomyopathy, mitral valve prolapse, pericarditis, endocrine disorders, and systemic illnesses such as diabetes mellitus and amyloidosis.

Cardiac arrest is a state of complete cessation of all cardiac function. Cardiac arrest can result from acute myocardial infarctions, prolonged asystole, severe bradycardia, or pulseless electrical activity. This condition requires immediate treatment to restore circulation and normalize vital functions.

Cardiogenic shock occurs when the heart pumps insufficient amounts of blood to maintain adequate organ perfusion. Cardiogenic shock often follows myocardial infarcts. Other causes of cardiogenic shock include pulmonary embolism, aortic dissection, massive trauma, septic shock, and drug overdose.

Coronary artery disease (CAD) is an atherosclerotic narrowing of one or more coronary arteries. CAD is the leading cause of morbidity and mortality in industrialized countries. There are several types of CAD: stable angina pectoris, unstable angina, silent ischemia, and sudden coronary death.

Coronary revascularization is the surgical or medical repair of occluded or stenosed coronary arteries. Revascularization treatments include balloon angioplasty, stenting, bypass surgery, and transmyocardial laser revascularization.

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