Major Cardiovascular Risk Factors
| Risk Factor | Impact | Modifiable? |
|---|---|---|
| Hypertension | Strongest modifiable risk factor for stroke | Yes |
| Hypercholesterolaemia (high LDL) | Core driver of atherosclerosis | Yes |
| Smoking | 2–3× heart attack risk | Yes — cessation most beneficial |
| Type 2 diabetes | 2–4× CV risk | Partially |
| Obesity (central) | Via BP, dyslipidaemia, insulin resistance | Yes |
| Physical inactivity | Independent risk factor | Yes |
| Family history | FH of premature CVD (<55M / <65F) | No (but identifies high-risk individuals to treat more aggressively) |
| Age and sex | Risk increases with age; male sex | No |
| Deprivation | Significant independent predictor (in QRISK3) | Partially |
Your QRISK3 Score
What Is QRISK3?
QRISK3 (available free at qrisk.org) estimates your 10-year probability of a heart attack or stroke based on age, sex, ethnicity, BP, cholesterol, smoking status, BMI, diabetes, and social deprivation. A risk of ≥10% qualifies for statin therapy under NICE guidance.
Primary Prevention Targets
| Target | Value | Why |
|---|---|---|
| Blood pressure | <130/80 mmHg | Every 10 mmHg systolic reduction → 40% less stroke |
| LDL cholesterol | <2.0 mmol/L (high risk); <3.0 (low risk) | Every 1 mmol/L LDL reduction → 22% less CVD event |
| HbA1c (diabetic) | <53 mmol/mol | Diabetic CVD risk substantially reduced with good control |
| Stop smoking | Complete cessation | Largest modifiable risk factor reduction |
| BMI | <25; waist <94cm(M) / <80cm(F) | Visceral fat drives metabolic risk |
Know Your NumbersAsk your GP for your last cholesterol, blood pressure, blood glucose, BMI, and smoking status. Input them into QRISK3. If your 10-year risk is ≥10%, a statin (atorvastatin 20 mg) significantly reduces your risk — it's a preventive medication, not a 'last resort'.
At what cholesterol level should I take a statin?
NICE recommends statins for anyone with QRISK3 ≥10% regardless of absolute cholesterol level. Also for all people with established CVD (secondary prevention) — target LDL <1.4 mmol/L.
Does aspirin prevent heart attacks?
Aspirin is no longer recommended for primary prevention (no previous heart attack or stroke) in most people — the bleeding risk outweighs the benefit. It remains essential for secondary prevention (after a heart attack or stroke).
What is the Mediterranean diet's effect on heart disease?
The PREDIMED trial (7,000+ patients) showed that a Mediterranean diet supplemented with extra virgin olive oil or nuts reduced major cardiovascular events by 30% compared to a low-fat diet — one of the most significant dietary intervention studies ever.
Can heart disease be reversed?
Some early atherosclerosis can be stabilised or partially reversed with aggressive LDL lowering (PCSK9 inhibitors achieve >60% regression in some trials), blood pressure control, and lifestyle changes. Established coronary disease is managed, not cured.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.