Table 1 Cardiological management of risk factors

Calcium score above the age- and gender-adjusted median and/or CAC score > 400

Prophylactic daily aspirin 75 mg and statins (atorvastatin 40 mg daily), if tolerated. If already on statins, increase the dose if possible

LDL cholesterol above 3 mmol/l

Statins (atorvastatin 40 mg daily), if tolerated. If already on statins, increase the dose if possible

LDL cholesterol above 3 mmol/l already receiving 80 mg atorvastatin

Supplement with ezetimib (10 mg daily)

LDL cholesterol above 3 mmol/l already receiving 80 mg atorvastatin and ezetimib

Switch to rosuvastatin (40 mg daily)

Hypertension (two measurements above 140/90 mmHg)

Perform 24-h ambulatory blood pressure monitoring. If hypertension is confirmed, initiate treatment according to guidelines

HbA1c > 48 mmol/mol

Refer to further evaluation and treatment by the general practitioner

Lifestyle risk factors

Educate on interventions according to guidelines (e.g., smoking cessation, regular exercise, nutritious diet)

Abnormal echocardiography

Handle according to findings and guidelines

Chest pain + risk factors ± ECG changes

Refer to coronary angiography