When the primary cardiovascular disease risk assessment tool, SCORE, is used in the initial evaluation and yields a 10 percent risk or higher, the likelihood of experiencing fatal cardiovascular events within the next decade is considered elevated. In this scenario, experts advise that it may be worthwhile to pursue a more detailed lipid analysis as part of a broader risk stratification. This view is shared by a leading figure at the National Center for Medical Research Cardiology, who serves as deputy director general for research and preventive cardiology. The recommendation underscores that a more advanced lipid panel can illuminate the aspects of cholesterol that drive atherosclerosis as well as those that help protect against it, highlighting both atherogenic fractions and high-density lipoprotein cholesterol, commonly referred to as the “good” cholesterol.
The clinician notes that the interpretation hinges on the balance of these lipid indicators, in conjunction with other key measurements, to determine whether there is a real risk of cardiovascular complications, the magnitude of that risk, and the components contributing to it. This integrated view helps clinicians tailor prevention strategies to each patient’s unique profile rather than relying on a single number alone.
Additionally, the assessment should be contextualized with blood pressure readings taken on multiple occasions, as well as glucose status and possibly glycated hemoglobin to gauge long-term blood sugar control. Diabetes can remain undetected for years while dramatically increasing cardiovascular risk, and obesity compounds that risk. When such a cluster of factors appears, proactive prevention becomes essential to reduce the chances of stroke and heart attack.
The discussion also highlights practical questions about how the carotid and coronary arteries are evaluated, the purpose of an ankle-arm index in vascular risk assessment, and the daily level of physical activity needed to lower cardiovascular risk. These considerations form part of a comprehensive approach to heart health and early intervention, emphasizing prevention as a continuous process rather than a one-off test.