Coronary Heart Disease Risk Score

Standard 4 of the National Service Framework for Coronary Heart Disease states that:

“General Practitioners and Primary Health Care teams should identify all people at significant risk of cardiovascular disease (CVD) but who have not yet developed symptoms and offer them appropriate advice and treatment to reduce their risk”.

Numerous risk calculators are available to calculate risk for coronary disease and these are all based on the Framingham model. The JBS III or the QRISK 2016 calculators are used for the calculation of cardiovascular disease risk. The South Birmingham PCT requires general practice to screen for CVD and any request for ‘CVD risk’ will generate a total cholesterol, HDL-cholesterol, creatinine and HbA1c (a yellow top and purple top bottle must be supplied). There are freely available calculators available to calculate a ‘CHD risk’ (Coronary heart disease risk) score (e.g. http://www.qintervention.org/)

Please note HDL-cholesterol is only measured when the CHD risk score is requested. We do not provide HDL-cholesterol otherwise on any request for a lipid profile.

Often we are asked to provide LDL-cholesterol calculations. For your convenience the calculation of LDL-cholesterol is provided below but you should recognise that this is only strictly valid where patients attend fasting for at least 12 hours in order to suppress triglyceride concentrations. Triglyceride concentrations >4.5 mmol/L negate the use of the calculation;

LDL cholesterol = Total cholesterol – HDL-cholesterol – (Triglyceride/2.19)