In assessing cardiovascular risk, imaging techniques can help when we have doubts.
Every time we try to have a more personalized approach in the approach to our patients, this includes the assessment of cardiovascular risk and this is what the latest cardiovascular risk guidelines of the European Society of Cardiology propose, in order to discuss the need with patients. to optimize cardiovascular risk factors based on individual risk.
Smoking cessation, promoting a healthy lifestyle and systolic blood pressure < 160 mmHg are recommended for all patients. For apparently healthy people, we can report on the risk of developing cardiovascular problems in the next 10 years using tables such as SCORE2 or SCORE2-OP, which take into account age, sex, BP numbers, LDL cholesterol levels and smoking; and classifies patients into low, intermediate, high and very high risk groups.
In addition to the classic cardiovascular disease risk factors included in the risk scales, there are other risk factors such as family history, presence of autoimmune diseases or other information related to our patient that can affect the risk calculation.
In cases in which the person's score is close to the limits that require decision-making, such as the need to start lipid-lowering treatment, or in the presence of non-classical risk factors, to achieve a better assessment of the individual risk, imaging techniques can help us.
The coronary calcium score or vascular ultrasound of the carotid and femoral arteries allow us to detect the presence of atheromatous plaques and can modify cardiovascular risk and change our attitude by reclassifying the risk, we can be more aggressive in controlling risk factors with pharmacological treatment or continue promoting a healthy lifestyle in patients who are at low risk.
The coronary calcium score is a cardiac CT without contrast that presents very few risks. It is a very simple test to perform that informs us of the presence and amount of calcium in the coronary arteries. In this way, when we detect calcium, it tells us that there are plaques. of atheroma; The amount of calcium is also a risk marker that compares us with what would be usual for our age. The coronary calcium score or vascular ultrasound of the carotid and femoral arteries can help us detect atheromatous plaques or their absence to achieve a better assessment of cardiovascular risk and a more individualized approach in cases that present intermediate risk or unconventional risk factors. .