QRISK2 cardiovascular disease 10 year risk score

I’ve just had my annual round of blood tests and apart from one result which came up as abnormal (and has done for the past 25 years), all the other results which I received online appeared OK. I was a little surprised when I received a text asking me to make a non-urgent face to face appointment to see my GP. I was even more surprised when I was offered an appointment in 2 days. The GP said that my QRISK2 cardiovascular disease 10 year risk score had risen from 19.4% to 30.1% in 5 years. My cholesterol had crept up from 3.7 to 4.1 (no statins and within range), non smoker, no other health issues and no close family history of strokes or heart attacks. My blood pressure was 138/78 which is a bit higher than normal and when checked at home after the blood tests it was 128/72. I was therefore concerned to hear that I was now subject to a high risk of stroke and or heart attack which took me very much by surprise.

It wasn’t my usual GP, but I was very comfortable with his approach. He said that he had to suggest that I should consider taking a statin but accepted that I could get my cholesterol back to nearer 3.7 without medication. I told him that I was not keen to take statins as I had seen the problems they had caused my wife over the years. I then asked him a question which I have often use as I get older, now, if I was your Dad, what would you recommend I should do. With a smile, he said I recommend you carry on as you are!

I just thought I’d share this and would be interested to hear any comments……

[mjames1]

Is that 4.1 your LDL or total cholesterol? What about your HDL? Funny story!

Jim

[Hidden in reply to mjames1]

4.1 total cholesterol 2.0 HDL level

2.1 HDL ratio

[mjames1 in reply to Hidden]

Why can't you use Mg/dl like the civilized US lol

Surprised they didn't do an LDL, but with an HDL that high and a 2.1 ratio, not sure why they'd want you on a statin but I know at least two people with similar stats they also were put on them. However, if it were me, I'd say, "no thank you".

Jim

[meadfoot]

I had exactly the same phone call two weeks ago tonight. I had my bloods done in June and all were ok and said no further action. One month later a GP, not my own, said exactly what you have been told. She said there was a new/different scoring regime and my risk of heart disease and stroke had therefore increased substantially. My BP is excellent, weight as it should be and diet extremely good. She wanted me on statins straight away and sent a script to chemist even though I was loath to take them.

I have no intention of taking them until I have my next EP consult in September. If he thinks I need them then I may well comply but certainly not before I speak with him.

[Auriculaire in reply to meadfoot]

I would want to know who was responsible for the new scoring system and if they had any conflicts of interest with statin manufacturers. I read some time ago of a study that assessed the Q risk algorithm and found that it consistently overestimated risk . That was the old one! My answer to any doc that urged me to take a statin would be that large scale studies in Scandinavia have shown that older women with cholesterol above the so called safe limit are the most long lived. Nor do they suffer more cardiovascular disease.

[meadfoot in reply to Auriculaire]

Yes I read that too. I found a paper yesterday released by Public Health England last summer explaining the calculations etc. made interesting reading. These days in particular I challenge everything. Similarly I refused to change my anticoagulation to a cheaper one for no other reason than it was cheaper. Sorry but no.

[Auriculaire in reply to meadfoot]

Given that individuals can have different experiences with side effects on different anticoagulants I think it is highly irresponsible to change somebody who is happy and stable on Apixaban to another one. If they stopped wasting money putting people on statins who are not going to benefit fom them ,they might not need to save on changing meds that people do have to take.

[meadfoot in reply to Auriculaire]

Exactly. Sadly not everyone feels confident enough to challenge and just do as advised or told. Thats not my style though.

[Auriculaire in reply to meadfoot]

Mine neither. I might as well have "non - compliant" tattooed on my forehead!

[BobD Volunteer]

As I have said many times. they have to have this conversation with all patients in order to top up their wages. QOF or quality outcome framework is something from the days of the Bliar administration .

[Lolabob123]

I had a similar scenario with the diabetic nurse refused the statins and got cholesterol back to a lower range never heard any thing since that was 4 years ago sounds like your docs on your side good luck regards stephen

[secondtry]

Good decision not to take a statin. I have had total cholesterol around 7 for 25 years; 8 years ago my heart & carotid arteries were tested and were all clear.

[McIvor]

ncbi.nlm.nih.gov/pmc/articl...

[Maggimunro]

Hmm, same happed to me Fj. After failing to get a GP appointment for something that was bothering me, I received a phone call asking me to make an appointment, which I got in a couple of days. I went into panic mode thinking something abnormal had come up on my recent blood tests. But not at all, it was once again the government funded urge to get people onto statins.

So I listened to his set talk about cholesterol and statins and politely refused because of the painful side effects when I had tried them a few years ago. I then told him we had become flexitarians and no longer ate red meat and had greatly reduced our cheese/ butter intake. He then looked at my latest blood tests and acknowledged my levels had indeed come down via lifestyle changes.

The saga continues. Six months later I received a telephone medicines review from the surgery pharmacist, who also urged me to take statins or an alternative. I again politely declined saying I had lost 16 pounds so far this year and I would wait until my next blood test in January 23 and see what further reduction in my cholesterol levels our lifestyle changes had made.

The pharmacist did tell me that the level of cholesterol I had back in January increased my likelihood of a heart attack or stroke by 30% but if one is intolerant of statins, what alternative does one have but to change ones lifestyle?

[Ewloe]

I’m on statins and need to be. But I’m aware that controversial nice guideline’s promote statins. Along with gps being paid incentives for prescribing them 🟰 a push to prescribe them that’s not always appropriate and needs questioning. I really don’t get why gps get paid extra to do certain things. To me that creates bias- as who doesn’t want to earn extra.

[pottypete1]

As you know we are all different. I have taken statins for some years without any problems.

Pete

[Hidden in reply to pottypete1]

As you know Pete, I’m passionate about folk taking anticoagulants if the medical evidence dictates that there is an increased stroke risk but I’m not sure I’d subscribe to taking statins if, as it is in my case, their cholesterol was well within range. Both my wife and her brother inherited quite severe cholesterol problems from their father and for several years they were taking the same (high) dose of the same statin. After a while, my wife began to get chronic leg pains whereas her brother was unaffected and remains so. Fortunately she has now found a statin which controls her cholesterol without the pain.

When I first discussed this with a cardiologist several years ago, he took the view that most people with a heart condition would benefit from taking a statin regardless of their cholesterol levels. I asked him if he had ever taken statins, I guess you can guess his answer 😉

[Tomred]

i also had call from gp urging me to take statins and on any visit to gp the same, and everytime i had blood test and rang for results the receptionist told me my cholesterol was rising each time, when i queried this with gp they told me my cholesterol was never as high as receptionist had said, my ep on the other hand told me my cholesterol was reasonable, go figure ...