Should heart age calculators be used alongside absolute cardiovascular disease risk assessment?
Abstract Background National estimates of ‘heart age’ by government health organisations in the US, UK and China show most people have an older heart age than current age. While most heart age calculators are promoted as a communication tool for lifestyle change, they may also be used to justify med...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12872-018-0760-1 |
| _version_ | 1828810510738391040 |
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| author | Carissa Bonner Katy Bell Jesse Jansen Paul Glasziou Les Irwig Jenny Doust Kirsten McCaffery |
| author_facet | Carissa Bonner Katy Bell Jesse Jansen Paul Glasziou Les Irwig Jenny Doust Kirsten McCaffery |
| author_sort | Carissa Bonner |
| collection | DOAJ |
| description | Abstract Background National estimates of ‘heart age’ by government health organisations in the US, UK and China show most people have an older heart age than current age. While most heart age calculators are promoted as a communication tool for lifestyle change, they may also be used to justify medication when clinical guidelines advocate their use alongside absolute risk assessment. However, only those at high absolute risk of a heart attack or stroke are likely to benefit from medication, and it is not always clear how heart age relates to absolute risk. This article aims to: 1) explain how heart age calculation methods relate to absolute risk guidelines; 2) summarise research investigating whether heart age improves risk communication; and 3) discuss implications for the use of medication and shared decision making in clinical practice. Main body There is a large and growing number of heart age models and online calculators, but the clinical meaning of an older heart age result is highly variable. An older heart age result may indicate low, moderate or high absolute risk of a heart attack or stroke in the next 5-10 years, and the same individual may receive a younger or older heart age result depending on which calculator is used. Heart age may help doctors convey the need to change lifestyle, but it cannot help patients make an informed choice about medication to reduce CVD risk. Conclusion Interactive heart age tools may be helpful as a communication tool to initiate lifestyle change to reduce risk factors. However, absolute risk should be used instead of heart age to enable informed decision making about medication, to avoid unnecessary treatment of low risk people. Evidence-based decision aids that improve patient understanding of absolute risk should be considered as alternatives to heart age calculators for lifestyle and medication decisions. |
| first_indexed | 2024-12-12T09:12:59Z |
| format | Article |
| id | doaj.art-e6a773db556b46238282ed0ab44494b4 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-12T09:12:59Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-e6a773db556b46238282ed0ab44494b42022-12-22T00:29:28ZengBMCBMC Cardiovascular Disorders1471-22612018-02-011811810.1186/s12872-018-0760-1Should heart age calculators be used alongside absolute cardiovascular disease risk assessment?Carissa Bonner0Katy Bell1Jesse Jansen2Paul Glasziou3Les Irwig4Jenny Doust5Kirsten McCaffery6Wiser Healthcare Program, Sydney School of Public Health, The University of SydneyWiser Healthcare Program, Sydney School of Public Health, The University of SydneyWiser Healthcare Program, Sydney School of Public Health, The University of SydneyWiser Healthcare Program, Sydney School of Public Health, The University of SydneyWiser Healthcare Program, Sydney School of Public Health, The University of SydneyWiser Healthcare Program, Sydney School of Public Health, The University of SydneyWiser Healthcare Program, Sydney School of Public Health, The University of SydneyAbstract Background National estimates of ‘heart age’ by government health organisations in the US, UK and China show most people have an older heart age than current age. While most heart age calculators are promoted as a communication tool for lifestyle change, they may also be used to justify medication when clinical guidelines advocate their use alongside absolute risk assessment. However, only those at high absolute risk of a heart attack or stroke are likely to benefit from medication, and it is not always clear how heart age relates to absolute risk. This article aims to: 1) explain how heart age calculation methods relate to absolute risk guidelines; 2) summarise research investigating whether heart age improves risk communication; and 3) discuss implications for the use of medication and shared decision making in clinical practice. Main body There is a large and growing number of heart age models and online calculators, but the clinical meaning of an older heart age result is highly variable. An older heart age result may indicate low, moderate or high absolute risk of a heart attack or stroke in the next 5-10 years, and the same individual may receive a younger or older heart age result depending on which calculator is used. Heart age may help doctors convey the need to change lifestyle, but it cannot help patients make an informed choice about medication to reduce CVD risk. Conclusion Interactive heart age tools may be helpful as a communication tool to initiate lifestyle change to reduce risk factors. However, absolute risk should be used instead of heart age to enable informed decision making about medication, to avoid unnecessary treatment of low risk people. Evidence-based decision aids that improve patient understanding of absolute risk should be considered as alternatives to heart age calculators for lifestyle and medication decisions.http://link.springer.com/article/10.1186/s12872-018-0760-1Cardiovascular riskRisk assessmentHeart ageOvertreatmentOverdiagnosis |
| spellingShingle | Carissa Bonner Katy Bell Jesse Jansen Paul Glasziou Les Irwig Jenny Doust Kirsten McCaffery Should heart age calculators be used alongside absolute cardiovascular disease risk assessment? BMC Cardiovascular Disorders Cardiovascular risk Risk assessment Heart age Overtreatment Overdiagnosis |
| title | Should heart age calculators be used alongside absolute cardiovascular disease risk assessment? |
| title_full | Should heart age calculators be used alongside absolute cardiovascular disease risk assessment? |
| title_fullStr | Should heart age calculators be used alongside absolute cardiovascular disease risk assessment? |
| title_full_unstemmed | Should heart age calculators be used alongside absolute cardiovascular disease risk assessment? |
| title_short | Should heart age calculators be used alongside absolute cardiovascular disease risk assessment? |
| title_sort | should heart age calculators be used alongside absolute cardiovascular disease risk assessment |
| topic | Cardiovascular risk Risk assessment Heart age Overtreatment Overdiagnosis |
| url | http://link.springer.com/article/10.1186/s12872-018-0760-1 |
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