Heart risk calculator due for an update

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Over 11 million Americans are at high risk of having a heart attack or stroke in the next 10 years — at least, that’s what the numbers say.
The equation doctors use to estimate cardiovascular risk is prone to miscalculation, according to a new study, meaning patients may be popping daily aspirin or statins at the wrong dosage. The stakes are higher for African-Americans.
With the old equation, 1 in 29 African-Americans may be incorrectly labeled very low or very high risk, according to the study. For example, a 46-year-old black man was estimated to have a 40 percent lower chance of having a heart attack or stroke than a white man of the same age and in identical health. In general, African-Americans are at higher risk of cardiovascular conditions than Caucasians, so miscalculations shouldn’t be taken lightly.
The heart risk calculator transforms patient information — age, gender, race, cholesterol levels, blood pressure, prescriptions, and whether they are diabetic or a smoker — into a percentage. That percentage estimates the chance that patient will have a heart attack or stroke in the next 10 years. The number is just one element of a patient’s overall cardiovascular evaluation, but it gives patients an idea of where they stand, health-wise. Then they can talk with their doctor about potential lifestyle modifications or preventative medications.
In 2013, the heart risk equations were updated by the American Heart Association and American College of Cardiology. The good news: the new math incorporated a variety of risk factors as well as data from minority populations, rather than exclusively Caucasians. The bad news: estimates generated by the new equation are often wrong.
“I saw a patient in clinic who I thought was at very high risk of having a stroke,” said Sanjay Basu, a Stanford physician and senior author of the new study. “I calculated his risk using the standard calculator and it kind of bizarrely suggested that he was very low risk, despite having quite high cholesterol and smoking tobacco.”


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