Heart Health Prevention

The Heart Health Risk Score

I don’t know of any other health coach who creates a Heart Health risk score for their clients. I came up with this because most of us understand risk and know how to work with percentages.

Perhaps the most important point is that prevention is the most powerful tool against cardiovascular disease.

The objective is to push a heart attack, heart failure, peripheral vascular disease, valvular disease, or a stroke as far into the future as possible.

Heart Health Risk Score Criteria

In a previous article, I discussed the overview of risk stratification. In this article, I want to dive deeper into the anatomy of this score.

I have broken the risk score up into the following categories. It’s a constantly evolving tool that must be revisited often.

1. Age

You might think age isn’t much of a lever, but I disagree. If you are reading this article and taking action now, you have decided to prevent heart disease earlier than your future self.

In fact, age is the number one risk factor for cardiovascular disease. The older we get, the higher the risk.

2. Family History

A parent who suffered a heart attack at 49 is a powerful risk contributor to the heart risk score. While an uncle who suffered heart disease at 79 may not tell us much about this risk.

Your mother’s health and the environment in which she carried the pregnancy portend future risk.

3. Comorbidities

Comorbidities include conditions and diseases which accelerate atherosclerosis or elevate the coagulation response in case of an unstable plaque.

Sleep apnea, hypertension, diabetes mellitus, obesity, elevated lipid profile, systemic inflammation, and certain lifestyle factors.

Getting more granular, hypogonadism, and severe menopausal symptoms negatively impact the Heart Health Risk Score.

4. Exercise Capacity

While some variables increase the risk of heart disease, others are protective and lower the overall cardiovascular risk score.

A healthy VO2 Max and a higher than average HRV are indicators and may be protective. In fact, exercise improves these metrics and is independently protective against cardiovascular disease.

5. Mental Health

Living in an area with high pollution, loud noise, or being under constant stress negatively impacts heart health. More so in those who don’t have compensatory coping mechanisms.

Ongoing financial stress, poor sleep, childhood adversities, and relationship stress also elevate the risk score.

6. Imaging Studies

Another category worth considering is imaging studies such as the Coronary Artery Calcium score (CAC) and a CT Angiogram (CTA).

These are often done preemptively but when they are part of a comprehensive heart risk assessment plan, they can be quite powerful.

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