- Cardiovascular diseases are the leading cause of death in Italy and worldwide
- Risk can be measured using validated tools like SCORE2 and ASCVD
- Knowing your risk allows you to act before an event occurs
- Blood pressure, cholesterol, and smoking are the most important and modifiable factors
What is cardiovascular risk?
Cardiovascular risk is the probability that a person will have a heart attack, stroke, or another heart and blood vessel disease in the next 10 years. It is not written in stone: it is an estimate based on measurable factors, many of which can be modified with the right attention.
Think of it this way: cardiovascular risk is like the weather. It doesn't tell you for sure what will happen, but it helps you understand whether to carry an umbrella—that is, whether to adopt preventive measures before the storm arrives.
How to measure cardiovascular risk
Doctors use mathematical formulas called risk scores. These are not simple guesses: they are equations derived from studies on tens of thousands of people, followed for years. The two main ones are:
SCORE2 — the European model
SCORE2 is the standard set by the European Society of Cardiology (ESC, 2021). It is calibrated for 4 geographic areas of Europe (low, moderate, high, and very high risk). Italy falls into the moderate risk area. It calculates the probability of a fatal or non-fatal cardiovascular event in the next 10 years. It also takes into account renal function (eGFR/CKD), a factor often overlooked.
ASCVD — the American model
The Pooled Cohort Equations by the AHA/ACC (2013) are calibrated for the US population. They also include ethnicity (white and African American). They are useful if you have American origins or want to compare the two models.
Risk factors: what you can change
| Factor | Modifiable? | How to act |
|---|---|---|
| High blood pressure | ✓ Yes | Diet, physical activity, medication if necessary |
| High LDL cholesterol | ✓ Yes | Nutrition, statins on medical advice |
| Smoking | ✓ Yes | Quitting cuts the risk in half within 1 year |
| Diabetes | ✓ Partially | Glycemic control, weight, physical activity |
| Age | ✗ No | More frequent monitoring after age 50 |
| Biological sex | ✗ No | Women have estrogen protection until menopause |
| Family history | ✗ No | If first-degree relatives had events < 55 years: early screening |
Blood pressure: what those numbers mean
Blood pressure is measured in millimeters of mercury (mmHg) and is expressed with two values: systolic (the first number, when the heart beats) and diastolic (the second, when the heart is at rest). A normal value is 120/80 mmHg.
A systolic pressure above 130 mmHg already increases cardiovascular risk. Above 140 mmHg, it is considered hypertension, which must be treated.
Hypertension is often called "the silent killer": it causes no symptoms for years, but slowly damages the heart, kidneys, and brain.
Cholesterol: it’s not all the same
Cholesterol is not a poison: it is a molecule essential for the body. The problem is excess, particularly of LDL cholesterol ("bad"), which deposits in the walls of the arteries, forming atherosclerotic plaques.
HDL cholesterol ("good") instead helps remove excess cholesterol. High HDL levels protect the heart.
Our calculator uses Non-HDL cholesterol (total minus HDL) according to the 2021 ESC guidelines, which consider it a more accurate predictor than LDL alone.
The role of the kidney: renal function and the heart
Few people know that chronic kidney disease (CKD) is a powerful, independent cardiovascular risk factor. The kidney and heart influence each other: a poorly functioning kidney increases blood pressure and promotes the accumulation of toxins that damage vessels.
Our SCORE2 calculator includes the correction for the glomerular filtration rate (eGFR): if you have an eGFR value, enter it for a more precise result. You can find it in routine blood tests.
How often should I calculate my cardiovascular risk?
Does the calculator replace a doctor?
I'm 35: does it make sense to calculate my risk now?
What you can do today
Even small changes have a real impact. Here is what really works, according to scientific evidence:
- 30 minutes of brisk walking per day reduces cardiovascular risk by 30-35%
- Quitting smoking halves the additional risk linked to tobacco after just 12 months
- Reducing salt to less than 5g/day lowers systolic pressure by 4-5 mmHg
- Mediterranean diet (olive oil, fish, vegetables, legumes) reduces cardiovascular events by 30% (PREDIMED study 2013)
- Managing weight: every 5 kg lost reduces systolic pressure by 4 mmHg