Major CVD prevention guidelines focus on long-term risk
Clinicians are being encouraged to use a new cardiovascular risk calculator, which has been developed by UK experts and focuses on the impact of factors affecting heart health throughout life.
Understanding the “true age” of a patient’s heart is key to curbing their lifetime risk of developing heart disease, according to major consensus guidance on CVD.
The third version of the Joint British Societies’ recommendations for the prevention of cardiovascular disease – known as JBS3 – has been published in the journal Heart.
It extends the current focus from targeting only those at high risk of CVD within the next 10 years to those with family and lifestyle factors at a younger age that indicates a high lifetime risk of developing it.
The approach is based on the growing evidence that there is a long pre-clinical phase to CVD, and that most heart attacks and strokes occur in people who are in the “intermediate” risk category.
“Primary care professionals will be able to better identify people who will benefit from prevention advice”
The recommendations include the JBS3 risk calculator, developed to help clinicians work out a patient’s cumulative lifetime risk of a CVD event.
This is worked out using current risk factors and predicts how many more years an individual can expect to live before a CVD event – if no corrective action is taken.
For example, a 35-year-old female smoker, with a systolic blood pressure of 160mmHg and total cholesterol of 7mmol/L, plus a family history of premature CVD, would have a true heart age of 47 and expect to survive to the age of 71 without having a CVD event. Her 10 year risk would be less than 2%.
But if this woman quit smoking, cut her total cholesterol to 4mmol/L and her systolic blood pressure to 130mmHg, her heart age would fall to 30. She could expect to live to the age of 85 before having a CVD event and more than halve her 10 year risk to less than 0.25%.
The calculator will be a pivotal component of the NHS Health Check programme aimed at 40-74 year olds, said the guideline authors.
Dr Mike Knapton, associate medical director of the British Heart Foundation, said: “Under the previous guidelines, we only started conversations with people about preventing disease after they’d significantly raised their risk.
“By taking this new life-time approach, primary care professionals will be able to better identify people who will benefit from prevention advice.”