Cardiac risk assessment

A comprehensive cardiac risk assessment with one of our cardiologists aims to identify problems or risk factors early, enabling you to take preventative steps. We provide evidence-based management strategies to help you avoid developing cardiovascular disease in the first place rather than requiring medical or surgical intervention after a life-altering cardiac event.

Cardiac risk assessment

Risk factors for cardiac disease

Cardiac disease encompasses a number of heart conditions, including coronary heart disease, heart attack, heart failure, and arrhythmia. While you may have certain heart disease risk factors that cannot be modified, such as genetics, there are still positive steps you can take to minimise your likelihood of developing a serious condition. 

To get a sense of your risk, you may use the Australian cardiovascular risk calculator available here. However, this does not replace a comprehensive assessment by a cardiologist.

Lifestyle factors


Smoking

The chemicals inhaled from smoking cause both short- and long-term detrimental effects on your heart and blood vessels. People who smoke are at a considerably higher risk of mortality from heart attack and stroke.

Poor Diet

A balanced, heart-healthy diet high in wholegrains, fibre, antioxidants, and healthy fats can protect your heart and reduce the impact of other risk factors, such as high cholesterol, high blood pressure, or being overweight. Excessive consumption of ultraprocessed foods, saturated fats, and sodium can all contribute to the development of cardiovascular disease.

Inactivity

Regular physical activity has been found to reduce heart disease risk by up to one third. In addition to keeping your heart fit, exercise helps to manage your body weight, blood pressure, blood glucose, and cholesterol, which all contribute to better heart health.

Alcohol

Excessive long-term alcohol consumption increases your risk of heart disease through its effects on your blood pressure, heart rate, and triglyceride levels. Heavy or binge drinking is associated with an increased risk of stroke, heart failure, and arrhythmia.

Co-existing medical conditions


High blood pressure (hypertension)

Uncontrolled hypertension is one of the most significant risk factors for heart disease. Unfortunately, most people develop hypertension without realising, underscoring the importance of regular health checks. Hypertension can be managed with medications and lifestyle changes.

High Cholesterol

Elevated cholesterol is a major risk factor for heart attack and stroke, as fatty deposits build up along the walls of your blood vessels and can cause a partial or full blockage. High cholesterol can be managed with dietary changes and medications.

Obesity

Being overweight or obese can increase your risk of heart disease by contributing to the development of problems such as hypertension, high cholesterol, and type 2 diabetes. People who are overweight or live with obesity are more likely to develop heart failure, coronary artery disease, and arrhythmia.

Diabetes

The elevated blood sugar levels found in diabetes can damage blood vessels throughout your body, including those supplying your heart. Diabetes is also associated with other risk factors for heart disease, including hypertension, high cholesterol, and being overweight. People living with diabetes are at a significantly higher risk of heart attack and stroke.

Poor Mental Health

Mental health conditions such as anxiety, depression, bipolar disorder, and others, are linked to an increased risk of heart disease. This relationship is thought to be largely due to how people living with a mental health condition engage in general self-care practices such as physical activity and eating well.

Non-modifiable factors


Age

Older age is a risk factor for many health conditions, not just those affecting the heart. Natural age-related structural changes to your heart, tissue damage that may have accumulated over time, and other contributing conditions that are more likely with age such as hypertension or high cholesterol, all increase your risk of heart disease as you get older.

Family history of heart disease

Having a family member who has heart disease does not automatically mean you will develop cardiac problems yourself, but it does increase the risk. Approximately one half of the risk of coronary artery disease is heritable, while the remaining risk is associated with lifestyle and environment, and may be modifiable. Though you cannot change your family history, you can minimise your overall heart disease risk through heart-healthy lifestyle changes and managing other risk factors such as hypertension.

Gender

In addition to being affected by the same heart disease risk factors as men, women are also exposed to certain female-specific risks. Pregnancy complications such as preeclampsia or gestational diabetes are risk factors for developing heart disease, as are the physiological changes that come with menopause.

Ethnicity

People of South Asian, Middle Eastern, Maori/Pacific Islander, and First Nations heritage are at a greater risk of developing heart disease. Unfortunately, these populations also often experience higher mortality from cardiac events, possibly due to a complex interaction between genetics, cultural factors, and access to timely cardiac care.

Cardiovascular risk assessment at Harbourside Cardiology

A thorough cardiac risk assessment with our cardiologists starts with a discussion of your lifestyle habits, medical history, and family history. Your cardiologist may also perform or organise basic tests for you, such as:

  • Blood pressure, whether in the office or with 24-hour blood pressure monitoring
  • Body weight, body mass index, and waist circumference
  • Blood tests to measure your total cholesterol, triglycerides, high- and low- density lipoprotein, blood sugar levels, full blood count, and other markers for heart disease risk

Depending on your known risk factors and degree of suspicion for heart disease, your cardiologist may perform more advanced tests, including:

  • Coronary artery calcium (CAC) scanning, a non-invasive CT scan designed to evaluate the degree of calcified plaque in your arteries
  • Electrocardiography (ECG), which measures the electrical activity of your heart
  • Echocardiography, a specialised ultrasound to assess your heart’s structure and function
  • Stress testing
  • Cardiac CT, including angiography, to identify structural abnormalities and blockages
  • Carotid ultrasound, which uses high-frequency soundwaves to generate an image of the carotid arteries in your neck

What happens after my cardiac risk assessment?

A cardiac risk assessment is all about giving you the information you need to take positive preventative steps to avoid developing heart disease. Your cardiologist will make specific recommendations around reducing your modifiable risk factors, which may involve behavioural changes, dietary modifications, or medication. We are committed to shared decision-making, as we believe patients who play a meaningful role in their own care are more likely to see better health outcomes.

Depending on whether your cardiac risk is low, intermediate, or high, your cardiologist will advise you when to next attend for a routine cardiac risk assessment.

Frequently Asked Questions

No, a coronary artery calcium scan is not a blanket recommendation for all patients undergoing a cardiac risk assessment. For people with high or very low risk of heart disease, or those with symptoms, other investigations or management strategies may be more appropriate. A CAC score is most useful for patients who are asymptomatic and at intermediate risk of heart disease. Calcium scoring is also not currently rebateable under Medicare and generally is associated with an out-of-pocket cost.

Yes, a cardiac risk assessment is most valuable before you notice symptoms as its purpose is to prevent you from developing heart disease at all. The general recommendations for a routine heart health risk check is to have one if you are aged between 45-79 years old, or between 35-79 years old if you live with diabetes. If you identify as a First Nations person, we recommend getting your first cardiac risk assessment from the age of 30.

We’re pleased to be able to offer most cardiac diagnostic tests in-clinic at Harbourside Cardiology. The main exception is CT imaging, for which we refer to a leading radiology provider. As we have a cardiology subspecialist (Dr Adam Berger) on the team, these imaging results can be interpreted in-house to streamline your care. 

Comprehensive cardiac care at Harbourside Cardiology, Sydney

At Harbourside Cardiology, our team is dedicated to providing holistic, patient-centred care that aligns with the most recent clinical guidelines and research. We are with you every step of your health journey, providing continuity of care of all heart conditions from initial assessment through to treatment and recovery.

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