American Heart Association’s Updated Tool Is a Game-Changer

Dr. Forbes

What if you had a crystal ball — something that could predict future health problems and tell you what exactly to expect as you get older?

With the updated Risk Prevention Tool from the American Heart Association, you may be able to do just that. (Well … sort of). Relying on new calculations with updated metrics, this tool, intended for primary prevention patients, can estimate the risk of cardiac disease and heart failure in currently healthy patients.

We took some time to chat with Bond Clinic’s new cardiologist, Dr. Jennifer Forbes, a specialist in clinical cardiology, nuclear cardiology, echocardiography, and congestive heart failure management, to learn more about this revolutionary tool.

What Is the Risk Prediction Calculator?

The Risk Prediction Calculator is a revolutionary tool developed by the American Heart Association and the Cardiovascular Kidney Metabolism Scientific Advisory Group to predict the risk of cardiovascular disease events.

Forbes

“The goal of the risk prediction calculator is to estimate the absolute risk of cardiac disease and heart failure and [to] allow clinicians and patients to engage in shared decision-making to intervene in targeting lifestyle behaviors and pharmacotherapies to ultimately reduce the risk and prevention of cardiovascular disease events,” Forbes explains.

This tool provides accurate risk estimates for cardiac events in patients aged 30 to 79 who have not yet been diagnosed with coronary heart disease, stroke, or heart failure. It can be used to identify and mitigate risk factors for cardiovascular disease before they escalate into complex conditions (ones that require intensive and expensive treatments).

The new calculator includes several measurements to calculate risk, including:

Sex
Age
Total and HDL cholesterol levels
Systolic blood pressure
Body mass index (BMI)
Kidney function (eGFR)
Presence of diabetes
Smoking status
The use of antihypertensive and lipid-lowering medications

The results of the Risk Prediction Calculator are reported as a 10-year and 30-year (in younger groups) risk estimate of cardio events for patients between ages 30 and 79.

The system looks at the risk of each outcome, including atherosclerotic cardiovascular disease (heart attack, stroke), heart failure, and the overall outcome of these combined. Based on the calculated risk, patients are categorized as low, borderline, intermediate, or high-risk.

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Despite its benefits, the Risk Prediction Calculator has its limitations. If a patient’s risk factor values are outside the acceptable ranges, the calculator may not be applicable, and the risk will need to be assessed and managed individually.

Forbes emphasizes the value of this tool, saying that because close to 80% of cardiac events are actually preventable, it’s important to “do whatever we can to motivate patients early to mitigate their risk.”

“By using this risk calculator, we are able to more accurately predict the risk of cardiac events in middle-aged individuals.”

What’s New for 2024?

Of course, this isn’t the first time the American Heart Association has released such a tool, but the updated version is a significant upgrade from the latest, which was released in 2013.

One of the most noteworthy features of the new calculator is that it not only allows for a 10-year risk estimate, but also a 30-year risk estimate. That advantage is valuable, Forbes says.

“In younger adults…if you can provide a longer estimate, it opens the door to incorporate early changes like preventative measures, lifestyle modifications, and different pharmacotherapies to lower the risk and prevent further issues.”

The latest risk calculator is also the first to take into account the risk of heart failure and include kidney and metabolic health as part of the assessment. This individualizes risk assessment and helps inform personalized treatment options.

Forbes notes that this is a game-changer, as it factors in the interdependence of different organ systems and how they cause a cluster of health issues. Previously, obesity, kidney disease, and heart disease were always treated in isolation, but with the inclusion of cardio-kidney-metabolic syndrome in this tool, a comprehensive picture of how they affect each other has now emerged.

This new approach is especially important given that one in three U.S. adults has three or more risk factors contributing to the syndrome. By acknowledging these connections and factoring differing stages of CKM syndrome into the risk assessment, the risk of heart attack, stroke, and heart failure can be better assessed, reducing the likelihood of cardiac disease.

How Accurate Is It?

Compared to its predecessor, which was released more than a decade ago, this new tool is more accurate and more effective at identifying and mitigating risk.

“This particular tool has an accuracy that’s increased, based on pooled cohort equations, mathematical formulas that use both social and biological factors to determine a patient’s risk over a period of time,” Forbes says.

Again, by factoring in CKM syndrome as part of the tool, it can also be more accurate in determining the absolute risk of heart attack, stroke, and kidney failure and disease. There are even options to include indices that include social measures as well.

“By adding those factors, you’re increasing the accuracy and initialization of the risk assessment,” says Forbes.

While the Risk Prediction Calculator is a valuable tool in identifying and mitigating risk factors for cardiovascular disease, it’s not intended for patients to use on their own. Instead, it’s intended for use in consultation with healthcare providers as part of a larger conversation about cardiovascular health and prevention strategies.

The best way to mitigate the risk of cardiovascular disease events, according to Forbes, is to work together through prevention and early intervention.