I'm Jan Proctor-King and I'm a primary care cardiovascular nurse.
A cardiovascular risk assessment
is where we collect lots of information about you,
usually for people who are aged 40 to 74.
And we collect information including their age, their sex, their ethnicity,
their family history of cardiovascular disease,
so that's their mother, father, brothers and sisters,
if they've had cardiovascular disease before the age of about 60.
55 and under for men and 65 and under for female relatives.
A cardiovascular disease would include a heart attack, a stroke,
a mini-stroke, angina,
evidence that the blood vessels to the heart or round the body
have been narrowed with atheroma.
We also look at an individual's blood pressure.
We look at the level of cholesterol in their blood,
we look at whether they have borderline raised blood sugar
or frank diabetes.
We look at their levels of physical activity,
we look at whether they smoke, very importantly.
We collect all this information together to estimate how likely it is
that they are at high risk of cardiovascular disease.
What happens when you have a cardiovascular risk assessment
is really quite simple,
but I think people expect it to be much more complicated.
You would initially visit to have some blood taken,
because to know the level of cholesterol in your blood, we need to take blood.
We can also look at the level of sugar in your blood, should that be necessary.
We take your blood pressure.
We take your weight.
We take your height.
When you've got the results back from the lab from your blood test
and all the other information,
you can then attend.
Usually you visit a nurse, a practice nurse or a health care professional.
With all this information together,
you're then able to discuss with the nurse what is your risk,
how's your lifestyle affecting your chances
of developing cardiovascular disease.
This gives you the opportunity to decide about your lifestyle
and decisions that you make.
You may want to lose weight and become more physically active
to prevent diabetes.
You may want to drink less.
You may want to alter the level of salt in your diet.
We look at cholesterol
and we measure it when you have a cardiovascular risk assessment
and we look at the ratio of bad cholesterol, the LDL,
and good cholesterol, HDL,
because not all cholesterol's bad for you.
HDL, high-density lipoprotein,
clears up cholesterol, takes it out of the system, is helpful.
LDL is the one that delivers cholesterol to our cells that we need
but can also line the blood vessels,
so we want some but not too much.
We can reduce LDL and we can reduce cholesterol levels with drugs,
and in some cases at a cardiovascular risk assessment
it will be shown that you're at a level high enough
to warrant offering you a drug
to lower the LDL and the cholesterol in your blood.
And it's an option that people can take.
But a cardiovascular risk assessment
lays out your options, from which you can choose all or none.
Some of those options are medication, many of them are lifestyle.
But it's not always clear what will be helpful to us
and the idea of a vascular risk assessment
is that we lay it out clearly, share information
so people can make informed decisions
about how they want to live the rest of their lives.