Assessing Risk of Developing Heart Artery Disease

• Major risk factors
• Are additional tests helpful as a checkup if one has not had a heart attack or angina?
• CT calcium scores- can be helpful as part of a routine checkup.
• Questions that can arise after a family member has an unexpected heart attack.
• Heart artery disease in families

After a Family Member/Friend Develops Heart Artery Disease Unexpectedly

After an unexpected heart attack, it is common for friends and family members to also become concerned about their own health.

These concerns can be much greater if the heart attack occurs in an otherwise fit and healthy friend or family member.

The friend or family member may not have had any predisposition to heart artery disease.

When a concerned individual, in this setting, has assessment of their own risk factor status, they might be informed that they are not at "high risk" of a heart attack in the next five years.

How Reliable is the Risk Assessment?

The assessment based on established risk factors has been shown to be very reliable. Investigations continue to try to improve this process.

Many persons that have raised concerns are referred for a treadmill test as part of a checkup and to allay anxiety.

Coronary Calcium Scoring with CT Scanning

Measurement of the amount of calcium in the heart arteries has been shown to improve the assessment of risk.

This test does help detect the small number of persons that are not accurately assessed by measurement of risk factors and are actually at "high risk". Proper identification of the correct risk status allows more informed decision making. We might commence medication for a "slightly high cholesterol" or "slightly high blood pressure".

In other words, a more accurate assessment might change recommendations for treatment.

Those that might be regarded as being at "moderate risk" may obtain the greatest benefit from this test. There are many questions yet to be answered regarding the usefulness of this test but, arguably, it is superior to treadmill testing in those that do not have any symptoms due to heart artery disease.

Healthy living guidelines from The National Heart Foundation of New Zealand.

Hitesh Patel, Cardiologist
April, 2007