CVD Risk & Blood Pressure: 30-Year Prediction
New Tool Assesses Long-Term Cardiovascular Disease Risk
A recent study published in Hypertension suggests that assessing an individual’s 30-year risk of cardiovascular disease (CVD) is crucial, along with the standard 10-year risk assessment. This long-term outlook can better inform decisions about when to initiate medication for stage 1 hypertension, according to the research.
The study highlights the PREVENTTM risk calculator, released by the American Heart Association in 2023, as a valuable tool. PREVENT estimates both 10-year and 30-year risks for heart attack, stroke, and heart failure, incorporating factors like kidney disease markers and the social deprivation index.Researchers compared PREVENT’s predictions to those of the Pooled Cohort equations (PCE), a previous risk prediction tool that doesn’t calculate 30-year risk or include factors like kidney function.
Researchers analyzed data from the U.S. National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020, focusing on 1,703 adults aged 30 to 79 with stage 1 hypertension. The analysis compared CVD risk estimates from both PREVENT and PCE.
the study revealed that the PREVENT calculator estimated a lower average 10-year risk for heart attack and stroke (2.9%) compared to the Pooled Cohort Equations (5.4%). However, it also showed that a important portion of individuals with a low 10-year risk according to PREVENT had a high 30-year risk (greater than or equal to 30%).
“Many peopel with stage 1 high blood pressure who are not likely to have a heart attack, stroke, or heart failure within the next 10 years may have a high risk over the next 30 years,” said Paul Muntner, Ph.D., M.H.S., FAHA, lead study author and a visiting professor at the University of Alabama at Birmingham. “People may want to discuss this with their doctors and consider starting antihypertensive medication to lower their blood pressure to reduce their risk for heart attack,stroke and heart failure across their lifetime even if they have a low short-term risk.”
Sadiya S. Khan, M.D., M.sc.,FAHA,chair of the writing group for the association’s 2023 scientific statement,emphasized the importance of considering both 10- and 30-year risk assessments. Khan noted that risk estimation is the first step in initiating patient-clinician discussions about cardiovascular prevention.
What’s next
The study suggests that health care professionals should consider both short-term and long-term cardiovascular risks when discussing treatment options with patients who have high blood pressure. The PREVENT calculator offers a valuable tool for assessing this long-term risk and making informed decisions about medication and lifestyle changes.