So, you've got your NHS Health Check results? The good news is that whatever your risk of a vascular condition, you can act now to improve them. Let's take a look at what the numbers mean.
Your overall risk score
You will get an overall score, but your NHS Health Check results should also be broken down for you into:
The healthcare professional who does your NHS Health Check will explain these to you and you will also be given your results in writing.
First, you'll be given your overall risk score. This score is worked out from the tests your healthcare professional did and the answers you gave to their questions. This score gives you an idea of your risk of developing a heart or circulation problem over the next 10 years.
Your doctor may describe this as low, moderate or high. This means:
- low – you have less than a 10% chance of a heart or circulation problem in the next 10 years
- moderate – you have a 10-20% chance of a heart or circulation problem in the next 10 years
- high – you have more than a 20% chance of a heart or circulation problem in the next 10 years
It's important to bear in mind that this is your own individual score and even if the risk sounds low, it is important to act on your NHS Health Check results.
It's also worth remembering that your risk also rises with age, so the next time you have an NHS Health Check your risk score may be much higher, even if your test results remain the same.
Your heart age
Your NHS Health Check can now also give you and your doctor a better understanding of the true age of your heart thanks to a new lifetime risk calculator.
The calculator works out your lifetime risk and heart age using information such as your family history of heart disease and your lifestyle choices, including whether you smoke. These risk factors are used to predict how many more years you can expect to live before you have a heart attack or stroke compared with someone without these particular factors – if you don't take action to improve your health.
"The risk calculator can now estimate cardiovascular risk over a much longer period than the 10-year risk," explains Dr Iain Simpson, a consultant cardiologist involved in developing the calculator.
"The problem with the 10-year risk is that it is biased in favour of age and females."
For example, a 35-year-old female smoker with high blood pressure (160 systolic pressure) and a high cholesterol level (7), plus a family history of heart disease, would have a true heart age of 47 and expect to survive to the age of 71 without having a heart attack or stroke. Her 10-year risk would be calculated as less than 2% because she is female and fairly young.
But the lifetime risk calculator shows that if she quit smoking and brought her blood pressure and cholesterol down into the healthy range, her heart age would fall to 30. She could expect to live to the age of 85 before having a heart attack or stroke and more than halve her 10-year risk to less than 0.25%.
"Knowing your lifetime risk allows you to invest in your cardiovascular health for the future," says Dr Simpson.
"This risk calculator aims to give power back to the patient and help them to make more informed decisions about how to manage their risk. It promotes lifestyle changes as early as possible and drug therapy only when necessary for the right people at the right time."
So there are some things about your risk that you can't change – like your age or family history. But the good news is that the most important factors in your risk score are changeable.
Your BMI score
Your BMI matters because your weight is closely linked to your long-term health.
A BMI below 18.5 indicates that you may be underweight. This could be a sign that you're not eating a healthy and balanced diet that contains enough energy for your needs. Or it may be a sign of a wide range of underlying health conditions.
People with an overweight BMI are at greater risk of a range of serious health conditions, including heart disease, stroke, type 2 diabetes and certain cancers.
If your score falls outside the healthy range (anything over a BMI of 25, or 23 if you are from a south Asian background), your health professional will discuss this with you and offer advice and support. They may, if necessary, advise weight management courses or weight loss pills that could help you to achieve a healthy weight, as well as looking at your diet and activity levels.
You can use the BMI healthy weight calculator to keep track of your BMI as your weight changes and to get advice on the best ways to achieve a healthy weight.
Your blood pressure score
When your blood pressure is measured, you'll get two results:
- a big number – indicating the pressure when your heart pumps blood out (known as systolic blood pressure)
- a smaller number – indicating the pressure when your heart rests (diastolic blood pressure)
Low blood pressure?
Low blood pressure doesn't necessarily indicate a health problem and is typically only a problem when it's accompanied by symptoms such as dizziness or fainting, which may be signs of a health condition.
Normal blood pressure is between 90/60 and 140/90. If your results fall outside this range, your healthcare professional will discuss this with you.
High blood pressure is a problem because it increases the risk of serious vascular health problems such as heart attack, stroke, type 2 diabetes and kidney disease. High blood pressure usually causes no symptoms, so it's possible to have high blood pressure without knowing it.
Having one raised blood pressure reading does not necessarily mean you have high blood pressure. Blood pressure can fluctuate throughout the day and in response to stress.
If you have a high blood pressure reading at your NHS Health Check, your healthcare professional may give you a blood pressure monitor to take home. You can use this to see whether your blood pressure level is high at different times of the day over several days, which could indicate a health problem.
The good news is that high blood pressure scores can be brought down by making changes such as cutting down on salt and caffeine, losing weight and becoming more active, while stopping smoking can cut the risk of heart attack or stroke. If necessary, your doctor may prescribe you with blood pressure-lowering drugs, but they will usually want you to try to make changes to your habits first before prescribing.
Your cholesterol score
Your cholesterol score will consist of two or three important results.
The first score is your total cholesterol level. Healthy adults should have a total cholesterol score of 5 or less. Unfortunately, two-thirds of people in Britain have higher cholesterol than this.
The second score is your LDL cholesterol score (often called "bad cholesterol"). This is the type of cholesterol that blocks the arteries. Healthy adults should have a LDL cholesterol score of 3 or less.
Your healthcare professional may also calculate your cholesterol ratio. A score of 4 or more may indicate heart or circulation problems.
If you've had your cholesterol test results and it was outside the healthy range, your health professional may have discussed this with you and given you advice on your diet and smoking, or possibly even medicines to lower your cholesterol level, such as statins.
These cholesterol scores are important because too much of the wrong sort of cholesterol in your blood can build up on the walls of your blood vessels, slowing or blocking the flow of blood to vital organs such as the heart or brain. This narrowing of the arteries (atherosclerosis) can cause heart attack, stroke and mini-stroke (TIA). It also increases the chance of a harmful blood clot developing anywhere in your body.
Your alcohol use score
You will be given a score about your alcohol use based on questions your healthcare professional asked you during your NHS Health Check. Each question has a score from 0 to 4 for the answers.
An alcohol use score of 7 if you are a woman and 8 if you are a man would indicate that you are drinking an amount of alcohol that is likely to be harming your health. Your healthcare professional will be able to advise you on ways to track your drinking and to cut down on alcohol.
If you score 20 more, you may well have an alcohol dependence disorder (alcoholism). Your healthcare professional should be able to refer you on for specialist support for cutting down on alcohol.
Drinking too much alcohol can raise your blood pressure and cause problems with your heart's rhythm. To find out more, read about the health effects of drinking too much.
Whatever the changes you're aiming to make, there's lots of information and advice on NHS Choices that can help you put together your own action plan.
You can start finding ways to improve your NHS Health Check results right now by reading our article about taking action to improve your numbers.