Heart disease risk prediction: A decade earlier

AHA's scientific statement on novel equations for cardiovascular risk.

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For the first time in a decade, the American Heart Association has improved how they predict heart disease risk, as per a study by Northwestern Medicine in the AHA’s Circulation journal. The new PREVENTTM model is more accurate and predicts cardiovascular disease risk at a younger age. Dr. Sadiya Khan, the study’s author, highlights its race-free approach, emphasizing the importance of health equity in predicting and preventing cardiovascular disease.

Khan, the Magerstadt Professor of Cardiovascular Epidemiology and an associate professor of medicine (cardiology) and preventive medicine (epidemiology) at Northwestern University Feinberg School of Medicine and a Northwestern Medicine preventive cardiologist said, “The new PREVENT risk calculator enables clinicians to quantify a person’s risk of CVD and may help people receive preventive care or treatment earlier to reduce CVD risk.”

Dr. Sadiya Khan, chair of the AHA’s Scientific Statement writing group, is unveiling the study’s results at the AHA’s annual Scientific Sessions in Philadelphia. The findings reveal that one in three U.S. adults has three or more risk factors for cardiovascular disease (CVD), kidney disease, or metabolic disorders. The new equations she introduces aim to better address prevention by incorporating the cardiovascular-kidney-metabolic (CKM) syndrome into CVD prevention efforts.

The updated model can now predict the risk of heart disease starting at age 30, 10 years earlier than before. It estimates the risk of total heart disease, including heart failure, heart attack, and stroke. This new approach also considers kidney health, a recently acknowledged risk factor for heart disease that can be managed and treated. Dr. Khan emphasizes the necessity for a new heart disease risk calculator, especially one incorporating measures of CKM syndrome, a prevalent condition in the U.S. as defined by the AHA.

A new approach to predicting health risks has been introduced, removing race from the equation to ensure fair and unbiased risk estimates. The updated risk calculator, PREVENT, now considers cardiovascular disease (CVD) risks for each biological sex, acknowledging unique differences observed in women. 

Additionally, it expands the age range from 30 to 79 years old, covering a more significant portion of the adult lifespan. This shift aligns with the movement by health associations, like the National Kidney Foundation, to eliminate race from clinical algorithms, emphasizing the need for equal and inclusive health assessments.

The most recent cardiovascular disease (CVD) risk calculator, the Pooled Cohort Equation, was unveiled in 2013.

Khan said, “However, lots of things have changed in the past ten years, including new treatments are now available for CKM conditions such as obesity, Type 2 diabetes and kidney disease.”

Based on health data from over 6 million adults of diverse backgrounds, the calculator includes an option to factor in social considerations. The CKM Health construct and PREVENT risk calculator offers a comprehensive approach to patient care, addressing total cardiovascular disease (CVD) risk, including heart failure. 

Dr. Khan suggests these tools could guide the use of new medications with benefits for reducing risks associated with obesity, diabetes, and kidney disease. The aim is to include these elements in future guideline updates for improved patient care.

In conclusion, this research advocates for a comprehensive heart disease risk prediction approach. The new model, PREVENT, predicts risk at a younger age and factors in CKM syndrome, contributing to a more holistic patient care approach. Dr. Khan proposes that these advancements be considered in future guideline updates, signaling a potential shift in how heart disease risk is assessed and managed.

Journal reference:

  1. Sadiya S. Khan, Josef Coresh, et al., Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association. Circulation. DOI: 10.1161/CIR.0000000000001191.
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