Bewertung des kardiovaskulären Gesundheitsrisikos
Begutachtet von Dr Krishna Vakharia, MRCGPZuletzt aktualisiert von Dr Colin Tidy, MRCGPZuletzt aktualisiert 13. Juni 2023
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In dieser Serie:Herz-Kreislauf-ErkrankungenMittelmeerdiät
A cardiovascular health risk assessment provides an accurate estimate of your risk of developing cardiovascular disease (eg, angina, heart attack, stroke or peripheral arterial disease) over the following 10 years, and provides an opportunity for you to make any changes that will reduce this risk.
If you already have a cardiovascular disease or diabetes then your risk does not need to be assessed because you are already in the high-risk group.
Auf einen Blick
A cardiovascular risk assessment estimates your chance of developing heart disease or stroke in the next 10 years.
This assessment is usually offered to people aged 40-74 who do not already have cardiovascular disease.
It involves questions about lifestyle, a blood test, and a blood pressure measurement.
The assessment calculates a percentage score, indicating your risk.
Lifestyle changes can help reduce your risk, even if it is low.
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Why is a cardiovascular risk assessment important?
Cardiovascular disease (CVD) accounts for almost a quarter of all deaths in the UK. Risk factors that increase the risk of developing CVD include:
Risk factors that cannot be changed: age, being male, having a family history of CVD, and ethnic background (eg, people of South Asian origin have an increased risk).
Risk factors that can be changed: smoking, high cholesterol, lack of physical activity, unhealthy diet, alcohol intake above recommended levels, being overweight.
Conditions that increase the risk of CVD include Bluthochdruck, Diabetes mellitus, chronische Nierenerkrankung, high lipids, rheumatoide Arthritis, Grippe, serious mental health problems, and periodontitis (gum disease).
By having a cardiovascular risk assessment, you can get an accurate estimate of your risk of developing CVD over the following 10 years and ways that you can reduce this risk.
What is a cardiovascular health risk assessment?
Zurück zum InhaltA cardiovascular risk assessment is an assessment of a person's risk of cardiovascular disease (CVD), such as the risk of developing heart disease or a stroke, and provides an assessment of the degree of risk.
The assessment provides an estimate of your risk of developing CVD over the following 10 years.
Within the Health Check Programme in England, everyone aged 40-74 years, not already diagnosed with cardiovascular disease (CVD), Diabetes, or chronische Nierenerkrankung, is invited every five years for a free health check, which includes and assessment of:
CVD risk.
Demenz (in those aged 65-74 years).
The Health Check also includes screening for diabetes mellitus and chronic kidney disease if you are at increased risk.
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Who should have a cardiovascular health risk assessment?
Zurück zum InhaltAll adults aged 40 or more should have a CVD risk assessment every five years apart from those who people who are already known to be at high risk of CVD, which includes anyone:
Bereits bekannt, CVD zu haben.
Aged 85 years or over (are assumed to be at high risk because of age alone, if a smoker or with high blood pressure.
Who is a person with familiärer Hypercholesterinämie, or other inherited disorders of lipid metabolism.
People with Typ-1-Diabetes mellitus oder chronische Nierenerkrankung stages 3, 4, or 5 are at high risk, and so a CVD risk assessment is not needed, but an assessment may help to make an informed choice on whether to take a medicine to reduce cholesterol (statin).
What does a cardiovascular health risk assessment involve?
Zurück zum InhaltA doctor or nurse will ask if you have any current lifestyle risk factors that increase your risk of developing a cardiovascular disease. These include smoking, Fettleibigkeit, a poor diet, lack of körperliche Aktivität and drinking a lot of alcohol.
You will then have a blood test to check your blood cholesterol and sugar (glucose) level. Your blood pressure will be measured.
A score is calculated based on several of these risk factors, your age and sex. An adjustment to the score is made for certain other risk factors such as strong family history and ethnic origin.
There are many different calculators. The QRISK®3 risk assessmentis used in England and Wales. This provides an estimate that is accurate for most people but may underestimate the CVD risk for some people if:
They have received treatment for HIV.
They are taking medicines that can cause high lipids (eg, immunosuppressants).
They have high blood levels of triglycerides (above 4.5 mmol/L).
They are already taking medicines to lower blood pressure or to Cholesterin zu senken.
They have recently given up smoking.
The assessment should be repeated every five years, but may be advised earlier if there are any changes that may affect your CVD risk.
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What does the assessment score mean?
Zurück zum InhaltYou are given a score as a percentage (%) chance. So, for example, if your score is 30% this means that you have a 30% chance of developing a cardiovascular disease within the following 10 years. This is the same as saying you have a 30 in 100 chance (or a 3 in 10 chance).
So in this example, 3 in 10 people with the same risk factors that you have will develop a cardiovascular disease within the following 10 years.
Who should be treated to reduce their cardiovascular health risk?
Zurück zum InhaltEveryone, including those at low risk of CVD, should follow lifestyle advice to help reduce CVD risk and stay healthy. The lifestyle advice includes:
Treatment with a medicine called a statin to reduce cholesterol is usually advised if you have an estimated 10-year CVD risk of 10% or more and if lifestyle interventions have not been effective. See also the leaflets on Statins and other Lipid-lowering Medicines und High Cholesterol.
What if I am at low risk?
Zurück zum InhaltIf you are at low risk, it does not mean you have no risk - just a lesser risk. Medication is not usually prescribed. However, you may be able to reduce whatever risk you do have even further by any relevant changes in your lifestyle (as described above).
Some people with a low risk buy a low-dose statin drug from a pharmacy to lower their cholesterol level. Statin medicines are available on prescription but only funded by the NHS if your risk is 10% or more.
If you do buy a statin and take it regularly, it is best to discuss this with a healthcare professional so that you can be advised about the risks and benefits of taking a statin.
Patientenauswahl für Herzkrankheit

Herzgesundheit und Blutgefäße
Akutes Koronarsyndrom
Der Begriff 'akutes Koronarsyndrom' (ACS) umfasst eine Reihe von Erkrankungen, einschließlich eines Herzinfarkts (Myokardinfarkt) und instabiler Angina, die durch eine plötzliche Verringerung des Blutflusses zu einem Teil des Herzmuskels verursacht werden. Dies wird normalerweise durch ein Blutgerinnsel verursacht.
von Dr. Rosalyn Adleman, MRCGP

Herzgesundheit und Blutgefäße
Aorteninsuffizienz
Aorteninsuffizienz wird manchmal auch als Aorteninkompetenz oder undichter Aortenklappe bezeichnet. Bei der Aorteninsuffizienz schließt die Klappe nicht richtig. Die Aortenklappe ist eine Herzklappe, die zwischen dem linken Ventrikel und der Aorta liegt. Daher fließt Blut zurück (regurgitiert) in den linken Ventrikel aus der Aorta. In einigen Fällen tritt Aorteninsuffizienz gleichzeitig mit Aortenstenose auf. Lesen Sie mehr über Aortenstenose.
von Dr. Colin Tidy, MRCGP
Häufig gestellte Fragen
What common conditions are associated with an increased risk of cardiovascular disease?
Conditions such as high blood pressure (hypertension), diabetes mellitus, chronic kidney disease, high levels of lipids (fats) in the blood, rheumatoid arthritis, influenza, serious mental health problems, and gum disease (periodontitis) all increase your risk of developing cardiovascular disease.
If I am already taking medication for high blood pressure or cholesterol, will my assessment still be accurate?
The QRISK®3 risk assessment, commonly used in England and Wales, may underestimate your CVD risk if you are already taking medicines to lower blood pressure or cholesterol. It's important to remember that the assessment should be repeated every five years, or sooner if there are significant changes that might affect your risk.
What kind of lifestyle changes can I make to improve my cardiovascular health, even if my risk is low?
Even if you have a low risk, you can still reduce it further by making lifestyle changes. This includes not smoking, losing weight if you are overweight or obese, eating a healthy diet, keeping your alcohol intake within recommended limits, and being physically active with regular exercise.
What does it mean if my cardiovascular risk score is, for example, 15%?
A score of 15% means that you have a 15% chance of developing a cardiovascular disease within the next 10 years. This is equivalent to saying that 15 out of every 100 people with the same risk factors as you will develop a cardiovascular disease in that timeframe.
Can I buy statin medication from a pharmacy, and should I discuss it with a healthcare professional?
Yes, some people with low risk choose to buy low-dose statin drugs from a pharmacy to lower their cholesterol. While statins are available on prescription and funded by the NHS for those with a 10% or more CVD risk, if you decide to buy and regularly take a statin, it is advisable to discuss this with a healthcare professional to understand the risks and benefits.
Weiterführende Literatur und Referenzen
- Risikobewertung und Prävention von Herz-Kreislauf-Erkrankungen; Scottish Intercollegiate Guidelines Network - SIGN (2017)
- Europäische Leitlinien 2021 zur Prävention von Herz-Kreislauf-Erkrankungen in der klinischen Praxis; Europäische Gesellschaft für Kardiologie (2021)
- Bewertung und Management des kardiovaskulären Risikos; NICE CKS, Mai 2023 (nur Zugang in Großbritannien)
- QRISK®3 calculator.
- NHS-Gesundheitschecks: Anwendung von All Our Health; GOV.UK. Aktualisiert März 2022.
- Kardiovaskuläre Risikobewertung und Lipidmodifikation; NICE Qualitätsstandard, Mai 2023
- Kardiovaskuläre Erkrankungen: Risikobewertung und -reduktion, einschließlich Lipidmodifikation; NICE Klinische Leitlinie (Juli 2014 - zuletzt aktualisiert Mai 2023) Ersetzt durch NG238
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Über den AutorVollständige Biografie anzeigen

Dr Colin Tidy, MRCGP
Allgemeinmediziner, Medizinischer Autor
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr. Colin Tidy ist ein NHS-Arzt mit Sitz in Oxfordshire.
Über den RezensentenVollständige Biografie anzeigen

Dr Krishna Vakharia, MRCGP
Chief Medical Officer für Gesundheit, Optum UK
MBChB, MRCGP(2013), BMedSci (hons), DFSRH, DRCOG, PGDipDerm (Distn)
Dr. Krishna Vakharia ist eine NHS-Hausärztin. Sie ist auch regelmäßige Prüferin für das postgraduale Diplom in Praktischer Dermatologie an der Cardiff University und zudem Chief Medical Officer für Gesundheit bei Optum UK.
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