All the stroke risk calculators I've taken had me at an extremely low risk. Mainly because they don't ask about familial plaque burden. My Dad had 80+% blockage in one of his carotid arteries, with a push from his doctor I could have gotten screened and prevented my stroke from the same condition.
Notice that Doctor Guide news - Neurology is out of date by 13 years since the WHO reclassified stroke in 2006, now a neurological disease not cardiovascular disease.
Screening Interval for High Cardiovascular Disease Risk Should be Individual
For
healthy individuals, the recommendation is a 5-yearly health check to
prevent cardiovascular diseases. However, according to a study published
in Lancet Public Health, a switch from 5-yearly screen intervals
to individualised intervals based on individual cardiovascular disease
risk level could annually prevent 8% of myocardial infarcts and strokes
without increasing healthcare costs.
Current American Heart Association, European Society of Cardiology, and UK National Health Service guidelines recommend a 5-yearly health check interval for screening of individuals at high cardiovascular disease risk. This health check covers measurement of a variety of risk factors including systolic blood pressure, cholesterol profile, blood glucose, and smoking status.
If lifestyle interventions are inadequate to reduce the risk, the guidelines recommend primary preventive medication such as statins. However, the 5-yearly screenings are not based on direct research evidence.
The study showed that current 5-year screening intervals were unnecessarily frequent for low-risk individuals and insufficiently frequent for intermediate-risk individuals.
“Our study shows that by optimising the screening intervals, 8% of myocardial infarcts and strokes could be prevented without increase in healthcare costs. This means that during the next 20 years, in the English population aged now 40 to 64, the number of new myocardial infarcts or strokes prevented annually could reach 5000,” says lead author Joni Lindbohm, MD, PhD, University of Helsinki, Helsinki, Finland.
The study followed over 7000 men and women over 2 decades. The authors estimated the optimal screening interval by following development of cardiovascular disease risk in 7000 English men and women who participated in the Whitehall II study. This study measured their cardiovascular disease risk factors according to the current guidelines in 5-yearly intervals over a 22-year follow-up and collected data on cardiovascular diseases using national electronic health and death records.
Those at low risk for cardiovascular diseases spent on average 9 years in that risk category before moving to intermediate-low risk. The participants then spent on average 7 years in this next category before progressing to intermediate-high risk. However, the time spent in intermediate-high risk was only 4 years; after this, over 70% of participants progressed to the high-risk category that leads to consideration of preventive medication if lifestyle intervention is insufficient to reduce the risk.
An individualised screening interval would enable more effective cardiovascular disease prevention by means of lifestyle intervention or preventive medication, because of more timely detection of those at high risk.
Reference: DOI:https://doi.org/10.1016/S2468-2667(19)30023-4
SOURCE: University of Helsinki
Current American Heart Association, European Society of Cardiology, and UK National Health Service guidelines recommend a 5-yearly health check interval for screening of individuals at high cardiovascular disease risk. This health check covers measurement of a variety of risk factors including systolic blood pressure, cholesterol profile, blood glucose, and smoking status.
If lifestyle interventions are inadequate to reduce the risk, the guidelines recommend primary preventive medication such as statins. However, the 5-yearly screenings are not based on direct research evidence.
The study showed that current 5-year screening intervals were unnecessarily frequent for low-risk individuals and insufficiently frequent for intermediate-risk individuals.
“Our study shows that by optimising the screening intervals, 8% of myocardial infarcts and strokes could be prevented without increase in healthcare costs. This means that during the next 20 years, in the English population aged now 40 to 64, the number of new myocardial infarcts or strokes prevented annually could reach 5000,” says lead author Joni Lindbohm, MD, PhD, University of Helsinki, Helsinki, Finland.
The study followed over 7000 men and women over 2 decades. The authors estimated the optimal screening interval by following development of cardiovascular disease risk in 7000 English men and women who participated in the Whitehall II study. This study measured their cardiovascular disease risk factors according to the current guidelines in 5-yearly intervals over a 22-year follow-up and collected data on cardiovascular diseases using national electronic health and death records.
Those at low risk for cardiovascular diseases spent on average 9 years in that risk category before moving to intermediate-low risk. The participants then spent on average 7 years in this next category before progressing to intermediate-high risk. However, the time spent in intermediate-high risk was only 4 years; after this, over 70% of participants progressed to the high-risk category that leads to consideration of preventive medication if lifestyle intervention is insufficient to reduce the risk.
An individualised screening interval would enable more effective cardiovascular disease prevention by means of lifestyle intervention or preventive medication, because of more timely detection of those at high risk.
Reference: DOI:https://doi.org/10.1016/S2468-2667(19)30023-4
SOURCE: University of Helsinki
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