After incorporating hypothetical updates into an equation used in the United States to calculate a person’s 10-year risk for developing atherosclerotic heart disease, researchers found that half of adults would be regrouped into lower-risk categories. The outcomes of incorporating these updates into future risk equations would come with trade-offs, including a predicted increase in the number of adults experiencing a heart attack or stroke and a reduction in the number of adults with side effects from medications used to lower cholesterol and blood pressure. These findings published in JAMA and the research was partially supported by NHLBI.
The authors conducted this research to assess the impact that incorporating new factors, such as indicators of kidney function, removing race, and using recent studies with diverse populations, would have on influencing population-level risks for heart and vascular disease. They found that if the updates they used were included in future equations, an estimated 15.8 million Americans would no longer be eligible for statins, a cholesterol-lowering therapy, or treatment to reduce high blood pressure. They predicted this could result in 107,000 cardiovascular events and 57,800 fewer cases of diabetes (a potential side effect from statins) throughout a 10-year period. Additional trade-offs would include a reduction in the number of people experiencing side effects from medications used to lower blood pressure, such as a reduction in blood flow to the heart.
The authors conclude that the current 10-year risk calculators for atherosclerotic heart disease should still be used, but these findings could be considered for future updates.