A cardiovascular risk assessment measures blood pressure, cholesterol, blood sugar and heart rhythm, then converts them into your risk of a heart attack or stroke over 10 years. It takes one appointment. A 30 minute consultation is £150 and the blood panel is £350.
Message the clinic and a doctor replies within 24 hours.
Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
Cardiovascular risk is the probability that you have a heart attack or a stroke in the next 10 years, calculated from your age, sex, ethnicity, blood pressure, cholesterol ratio, smoking status, weight and family history.The BMJ Hippisley Cox, 2017
The calculation matters because no single number decides anything on its own. A cholesterol of 6 means something different at 40 with normal blood pressure than at 62 with treated hypertension, and treatment follows the combined figure rather than any one reading.NICE NG238, 2023
There are usually no symptoms. High blood pressure and raised cholesterol both cause nothing at all until the event they lead to, which is the entire argument for measuring rather than waiting.NICE NG136, 2023
The drivers are blood pressure, cholesterol carrying particles, blood sugar, smoking, weight and inherited risk. Around a third of atrial fibrillation, a common cause of stroke, is silent until it is looked for.NICE NG196, 2021
Send us what you are seeing and we will tell you what it is likely to be.
The appointment measures blood pressure properly in both arms, listens to the heart, checks the pulse for an irregular rhythm, records height, weight and waist, and takes bloods for a full lipid profile, HbA1c, kidney and liver function.NICE NG238, 2023
The 10 year risk is calculated with a validated tool developed and tested on UK primary care records rather than on an American population, which matters because ethnicity and deprivation both change the answer.The BMJ Hippisley Cox, 2017
Lipoprotein(a) is measured once in a lifetime. It is inherited, it is not changed by diet or by standard cholesterol treatment, and a raised level moves someone from moderate risk to high risk in a way nothing else on the panel shows.European Heart Journal EAS consensus, 2022
Doing nothing, and knowing the number
A legitimate outcome. A 42 year old with a 10 year risk under 5% and no family history is told that plainly and asked to come back in 5 years.NICE NG238, 2023
Diet, activity and weight
Moves blood pressure, lipids and blood sugar together, which nothing else does. It is slower than medication and it is the only intervention that improves all three at once.European Heart Journal ESC guideline, 2021
Stopping smoking
The single largest modifiable reduction available to a smoker, and larger than any tablet on the list.European Heart Journal ESC guideline, 2021
Lipid lowering treatment
Every 1 mmol per litre reduction in LDL cholesterol reduces major vascular events by around a fifth per year of treatment, and the benefit is proportional to the starting risk rather than to the starting cholesterol.The Lancet Baigent, 2010
Blood pressure treatment
Chosen by age and ethnicity rather than by preference, and titrated to a target rather than started and left.NICE NG136, 2023
A rhythm check where the pulse is irregular
Atrial fibrillation raises stroke risk substantially and the treatment for it is different from everything else on this list, so it is looked for rather than assumed absent.NICE NG196, 2021
Blood pressure treatment shows its effect within 4 weeks and is titrated at 4 to 6 week intervals until it is at target. Lipid treatment is rechecked at 3 months, and the number that matters is the percentage fall from your own starting point rather than a population average.NICE NG238, 2023
The inconvenient half. Intensive blood pressure lowering reduced cardiovascular events and death in a large randomised trial, and it also produced more low blood pressure, more fainting and more kidney injury in the intensively treated group. Tighter is better on average and it is not free.New England Journal of Medicine Wright, 2015
A risk score is a probability rather than a prediction. A 10% 10 year risk means 90 people in 100 will not have an event, and treatment shifts the odds rather than removing them. The decision is yours once the numbers are on the table.General Medical Council GMC guidance, 2020
Measure your own blood pressure at home for 7 days before the appointment. Sitting, arm supported, twice each morning and twice each evening, and discard day one. The average of the remaining days is a better measure than anything taken once in a clinic room.NICE NG136, 2023
Bring the family history in detail. Which relative, which event, and at what age. A first degree relative with a heart attack under 60 changes your calculated risk, and the age is the part people cannot remember when they are asked in the room.The BMJ Hippisley Cox, 2017
Measure your waist at the navel, standing, after breathing out. Over 94cm in a man or 80cm in a woman raises metabolic risk independently of weight, and it is a number you can act on without any appointment at all.European Heart Journal ESC guideline, 2021
Do not buy a coronary calcium scan as a first step. It is useful where the calculated risk sits on a borderline and the decision could still go either way, and it changes nothing for someone whose risk is already clearly low or clearly high.European Heart Journal ESC guideline, 2021
Do not buy an annual lipoprotein(a) test. It is inherited and it does not meaningfully change, so once in a lifetime is the correct frequency and anybody selling it yearly is selling you the same result again.European Heart Journal EAS consensus, 2022
Do not buy a full body scan to answer a cardiovascular question. It is the most expensive way to not answer it, and the four measurements that do answer it cost a fraction of one.NICE NG238, 2023
Step 1
Blood pressure in both arms, the pulse checked for rhythm, weight and waist, and bloods for lipids, HbA1c, kidney and liver.
Step 2
Your 10 year risk calculated with a tool validated on UK records, explained as a probability rather than as a verdict.
Step 3
What to change, what to treat, what to leave, and when the next measurement happens. The plan is judged against numbers rather than against how you feel.
Ask before you book if you are not sure this is the right appointment.
Blood pressure, cholesterol, blood sugar and heart rhythm measured together, then converted into your probability of a heart attack or stroke over the next 10 years. It takes one 30 minute appointment plus a blood test, and it produces a number rather than a reassurance.
From 40 for most people, and earlier where there is a family history of heart disease under 60, a known lipid disorder, high blood pressure, diabetes or South Asian ancestry. The point of the calculation is that it weighs those together rather than one at a time.
A 30 minute consultation with blood pressure, examination and the risk calculation is £150. The Core blood panel is £350 and the Longevity panel with ApoB and lipoprotein(a) is £1,395. The review by telephone once results are back is £59.
Not for a standard lipid profile or HbA1c. Non fasting samples are used routinely and give results that are just as usable for risk calculation. If a fasting sample is needed for another reason you are told when you book rather than on the day.
It is an inherited cholesterol carrying particle that raises risk independently and is not changed by diet or by standard lipid treatment. Because it is genetically set it is measured once in a lifetime, and a raised level changes how aggressively everything else is treated.
Only if the numbers and your own decision point that way. A risk under 10% is usually managed by changing what can be changed. Above that the benefit of treatment is discussed as a probability, and the choice is yours once the trade is on the table.
Only where your calculated risk sits on a borderline and the treatment decision could still go either way. Where risk is clearly low or clearly high it changes nothing, so we say no to it more often than we arrange it.
Every 5 years where risk is low and nothing has changed, annually where you are on treatment and being titrated to a target. Repeating a low risk assessment every year produces the same answer at the same cost.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
European Heart Journal, European Atherosclerosis Society
Lipoprotein(a) in atherosclerotic cardiovascular disease, consensus statementEAS consensus, 2022
European Heart Journal, European Society of Cardiology
Guidelines on cardiovascular disease prevention in clinical practiceESC guideline, 2021
General Medical Council
Decision making and consentGMC guidance, 2020
New England Journal of Medicine
A randomised trial of intensive versus standard blood pressure control, SPRINTWright, 2015
NICE
NICE
Cardiovascular disease, risk assessment and reduction, including lipid modificationNG238, 2023
NICE
The BMJ
Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular diseaseHippisley Cox, 2017
The Lancet
Efficacy and safety of more intensive lowering of LDL cholesterol, Cholesterol Treatment Trialists CollaborationBaigent, 2010
Written by the clinical team at The Wellness. Awaiting clinical sign off.
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