What Increases Your Risk?

Cholesterol levels – in particular, LDL cholesterol – are important for understanding your risk of heart disease and stroke. 

But cholesterol is only one piece of the puzzle. Starting as early as age 30, your care team will use information about your health to estimate your short- and long-term risk of having a heart attack or stroke.

One such tool called PREVENT-ASCVD can help:

• Estimate how likely you are to have a serious heart problem or stroke in the next 10 or 30 years and
• You discuss with your care team whether starting a statin or adjusting cholesterol-lowering therapy is needed

This score includes information that is often collected during your annual physical, including your cholesterol test results plus:

• Your age
• Blood pressure – and whether you take medicine to treat it
• Body mass index (BMI)  
• Diabetes
• Reduced kidney function

These factors provide a baseline or starting estimate of risk. Your care team will also consider other health conditions or “risk enhancers” that will also help you make decisions about treatment. 

Other factors can also raise a person’s risk of heart problems.

For example, some people have inherit conditions that raise cholesterol levels, such as elevated lipoprotein (a) or familial hypercholesterolemia, or FH. Other “risk enhancers” include:

• A family history of heart disease
• Chronic inflammatory conditions such as lupus or rheumatoid arthritis
• Cardiometabolic conditions, such as overweight/obesity, diabetes or chronic kidney disease
• Elevated triglycerides, apolipoprotein B (apoB) or high-sensitivity C-reactive protein (hsCRP)
• South Asian ancestry and some other racial or ethnic groups that may develop atherosclerosis at a younger age
• Reproductive or pregnancy-related conditions such as:
• Starting a period before age 10
• Early menopause (before age 45)
• Preeclampsia, gestational diabetes, preterm delivery (before 37 weeks)

Lifestyle habits can also affect your risk of a future heart attack or stroke. Unhealthy habits include:

• Eating foods high in sugars and unhealthy fats
• Not getting regular physical activity
• Smoking or vaping
• Being overweight
• Not getting regular care

Be sure to talk with your care team if you have any of the above conditions or health habits. This will help you together talk about the best way to lower your heart risks.