QRISK: how it works and what your score means

What is QRISK?

QRISK is an online calculator to estimate your risk of developing cardiovascular disease (sometimes called heart and circulatory disease) over the next 10 years.

It works by using information about your health to work out your risk. It does not tell you that you will definitely get a cardiovascular disease like heart attack, stroke, angina, peripheral arterial disease, coronary heart disease, or transient ischaemic attack.

Instead, it provides an estimate of your likelihood of developing cardiovascular disease within the next decade. This allows you and your doctor to take steps to reduce your risk if needed.

How does the QRISK calculator work?

The calculator uses a complex algorithm (a set of calculations), based on research into large numbers of people, to generate your QRISK score.

It considers risk factors that influence your chances of developing cardiovascular disease. These include:

• Age, sex, ethnic background and where you live: all of these can have an impact on your risk.
• Lifestyle: whether you smoke and/or have obesity.
• Existing medical conditions: such as diabetes, chronic kidney disease, atrial fibrillation or rheumatoid arthritis.
• Family history: whether a parent or sibling had coronary heart disease before the age of 60.
• Blood pressure: whether you are currently taking medication for high blood pressure.

When is QRISK used?

QRISK is not designed for people who already have cardiovascular disease (though it can be used for people with type 2 diabetes) and people who are taking statins for high cholesterol, as they are already known to be at high risk.

It’s most often used at an NHS health check – these are checks for people aged 40 to 74 who have not already been diagnosed with certain pre-existing conditions.

Your GP might also use QRISK to assess your risk if you’ve raised concerns about your heart health or risk factors like high blood pressure or family history.

QRISK can be used for people aged between 25 and 84. After 85 your risk of cardiovascular disease is automatically deemed to be high because of your age.

What do the QRISK scores mean?

After your information is entered into the QRISK calculator, you’ll be given a QRISK score. Here’s what the score might mean:

Less than 10 per cent: low risk

This suggests a relatively low chance of developing cardiovascular disease in the next 10 years. It’s still important to maintain a healthy lifestyle, especially as your lifetime risk is likely to be higher.

10 to 20 per cent: moderate risk

That means you have at least a 10 in 100 chance, and up to a 20 in 100 chance, of developing cardiovascular disease within 10 years. Your doctor will discuss lifestyle changes with you and may recommend medication like a statin to help lower your risk.

20 per cent or higher: high risk

This means you have a 20 in a 100 chance or more of developing cardiovascular disease within 10 years. Your doctor will recommend medicines like statins to lower your risk, as well as lifestyle changes. Further tests or referrals to a heart specialist might also be considered.

Does QRISK have limitations?

QRISK is mainly a tool to assess your 10-year risk of cardiovascular disease, but there is also another version of the tool that focuses on lifetime risk of cardiovascular disease.

This means you could be told that you have a low 10-year risk, but a high lifetime risk, especially if you’re younger and have risk factors.

Understanding your lifetime risk can be more helpful in motivating you to make changes that could help you to stay healthy for longer.

The current version of the tool – called QRISK 3 – does not fully consider certain conditions and treatments that are now thought to increase your risk.

These include autoimmune conditions, having a learning disability, COPD (chronic obstructive pulmonary disease), certain cancers, pre-eclampsia, severe mental illness, postnatal depression, and taking immunosuppressant drugs and HIV medicines.

Your doctor should help you to understand what your QRISK score means in relation your own circumstances.

I’ve got my QRISK score. What do I do now?

Whatever your QRISK score, the most important thing to remember is that you can take steps to reduce your risk of cardiovascular disease.

This includes eating a healthy diet, with plenty of fruits, vegetables and wholegrains, keeping to a healthy weight and being active, as well as quitting smoking if you smoke.

If you’ve been prescribed medicines for high blood pressure or high cholesterol, it’s a good idea to take them. If you have any concerns, speak to your doctor or nurse.

What to read next...