Identifying cardiovascular risk

Several risk factors increase the likelihood of developing CVD. Identifying people at increased risk allows preventative measures to be implemented before CVD develops. Risk factors can broadly be divided into modifiable and non-modifiable categories:

Modifiable risk factors:

• Weight
• Smoking status
• Blood pressure
• Cholesterol
• Diabetes.

Non-modifiable risk factors:

• Age
• Sex
• Ethnicity
• Family history.

Identifying someone at increased risk provides an opportunity to introduce preventative interventions, such as lifestyle modification or medicines to reduce cardiovascular risk, with the aim of delaying or preventing the onset of cardiovascular disease.

Assessment of cardiovascular risk is already embedded within the NHS Health Check programme, but more widespread risk assessment could improve the identification of individuals who may benefit from earlier intervention.

The recommended approach to identifying a person at increased risk of CVD is the use of a validated cardiovascular risk score.

A 10-year CVD risk score of 10 per cent or more is considered to indicate a high level of risk and, alongside lifestyle interventions, is the threshold for considering lipid-lowering therapy to reduce cardiovascular risk.

If a patient is identified as being at high risk through POCT or formal risk assessment, community pharmacy teams should use the opportunity to discuss lifestyle modification and introduce the option of lipid-lowering therapy (LLT).

At present, patients would generally need to be referred to general practice for further evaluation. If treatment is initiated, the patient may subsequently return to the pharmacy with their prescription, creating an opportunity for a further consultation through the New Medicine Service.