CHADS2 Score

Your heart normally has a regular, coordinated pattern of contractions and periods of relaxation that allow the blood to move into the ventricles in a predictable rhythm. When you have atrial fibrillation, also known as AFib, the two upper chambers of your heart quiver instead of beating regularly. As a result, blood is not efficiently pumped from the heart’s upper chambers to its lower chambers, which can allow blood to pool and clot. That clotted blood can cause a stroke if it travels and blocks the brain’s blood supply.

Using a test called a CHADS2 score, doctors can more easily determine the risk for stroke in patients with AFib.

What Are the Main Stroke Risk Factors?

In addition to AFib, several other factors can place you at risk for stroke, including:

  • high blood pressure
  • smoking
  • diabetes
  • high cholesterol
  • obesity
  • carotid artery disease
  • peripheral artery disease
  • age
  • family history
  • prior stroke or heart attack

What Is Your CHADS2 Score?

Researchers developed the CHADS2 test to help people, specifically those with AFib, determine their stroke risk. Later, the test was updated to CHA2DS2-VASc to include additional risk factors. The letters stand for certain risk factors:

  • C: Congestive heart failure
  • H: Hypertension (high blood pressure)
  • A2 (worth two points): Age equal or greater than 75
  • D: Diabetes mellitus
  • S2 (worth 2 points): Stroke or TIA (transient ischemic attack or mini-stroke)
  • V: Vascular disease
  • A: Age 65–74
  • Sc: Sex category (male or female)

Each factor is assigned one point, except for those marked with a subscript 2, which means it is worth two points. Scores of 0–1 indicate a low to intermediate risk, and scores of 2 or greater indicate a higher risk of stroke. According to research published in the journal Medicine, the CHA2DS2-VASc score correctly predicted the patients who were at a high risk of death within three to five years. The same study found that each increase of 1 point in the CHA2DS2-VASc score almost doubled the death probability.

Physicians use this score to help determine whether patients with AFib need to stay on a regimen of anticoagulants to thin the blood and reduce the risk of clots. Knowing your score can also help you target lifestyle changes that can help you lower your stroke risk.

Preventing Stroke

By focusing on risk factors that you can control, you can make healthy lifestyle changes that will reduce your overall stroke risk.

  • Avoid smoking and second-hand smoke.
  • Move more and get plenty of physical activity.
  • Stay at a healthy weight or get on a weight-loss plan if necessary.
  • Eat a healthy diet with lots of fruits, veggies, whole grains and low-fat dairy while limiting salt and sugar.
  • Take medications for high blood pressure and AFib as prescribed and manage other health conditions as directed by your doctor. 
  • Cut back on alcohol, drinking no more than two alcoholic beverages per day for men or one for women.

If you need help making healthy changes, talk to your doctor about ways you can incorporate healthy habits into your daily routine.