What’s the big deal about risk?
Doctors calculate risk for both whole populations and individuals to assess what their likelihood of acquiring a disease or illness is. This is then weighed up by possible harmful effects of the treatment and a decision is made as to what method is used for treatment/prevention. When risk is taken into consideration it is generally done so in either absolute or relative terms.
Absolute Risk
This is the difference of an event from occurring between 2 populations. The table below highlights the absolute risk (in high risk patients) of a patient getting heart disease. The treatment group includes patients taking medication, whereas the placebo group are not taking any medications; As shown below the difference or ‘Absolute Risk’ of a person not taking medication is the difference between 40–30 % = 10%.
Relative Risk
This is the difference between the event rates in relative terms. In the table below, the treated group (taking medication) in trial 2 or the ‘low risk’ group (10%) is 25% less likely to be affected by heart disease than the placebo (not taking medication) group (7.5%). This can be somewhat misleading to the individual, considering the absolute difference would only be 2.5%, whereas the relative risk can be stated as 25%.
The main risk factors to manage
When your individual risk is assessed the main factors that are taken into consideration are;
· Age
· Sex
· Family History
· Obesity
· Sedentary lifestyle
· Cholesterol
· Blood Pressure
· Current Diabetic
· Smoking Status
Based on the results of each of the above, an estimation can be made to give you a good idea of where your risk lies in association to a number of diseases (as listed below). Most of the risk factors are modifiable, however there are a few that are non modifiable (age, sex and family history). These modifiable risk factors can more often than not can be reduced with regular exercise and a change in diet.
What am I at risk of?
If one or more of the above risk factors are present, your risk of being diagnosed with these diseases can be increased;
· Heart Disease - The leading cause of death in Australia (accounting for 16% of all deaths) and one of the most preventable;
· Cancer - 1 in 2 men and 1 in 3 woman will be diagnosed with cancer by the age of 85;
· Stroke - In 2011, Australians will suffer around 60,000 new and recurrent strokes primarily caused by high blood pressure;
· Diabetes - 275 Australians develop diabetes every day making it Australia’s fasting growing chronic disease. Up to 60% of cases of type 2 diabetes can be prevented through lifestyle and diet modification.
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| ***Refer to the blog post "What is your risk of developing cardiovascular disease" to view the Australian risk factor charts. |
An example of CVD risk measurement
· David is a 49–year-old male.
· He has smoked a packet of cigarettes every day for the past 20 years.
· He has more than five pots/middies of full strength beer at least three times a week.
· He has high blood pressure, often measured at 160mmHg/ 100 mmHg.
· He does not have diabetes.
· He has a total cholesterol reading of 6 mmol/L.
· He weighs 70 kg.
· His father died of stroke at 70 years of age.
· His 85-year-old mother is still alive, but has high blood pressure and diabetes.
· David’s doctor considers these risk factors, as well as whether or not David has any conditions, such as chronic kidney disease, that already put him at high risk of CVD, before calculating his risk.
· Using a risk calculator, the doctor works out that David’s heart and stroke risk score is 16%.
This means that David has a 16% chance of experiencing a cardiovascular event such as a heart attack in the next 5 years - Or a 1 in 3 (32 %) chance of a cardiovascular event before he retires!
References
www.abs.gov.au
www.cancer.org.au
www.heartfoundation.com.au
www.strokefoundation.com.au
For more information
www.yourdiseaserisk.wustl.edu
www.ausdrisk.com
Wesley Corporate Health
Level 2 / 46 Edward Street
Brisbane Qld 4000
Phone: 07 3234 2600
Email: info@weshealth.com.au
Disclaimer
This Fact Sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.
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