Study suggests doctors Should Assess Both Short and Long-Term Heart Risks in High BP Patients
New Delhi: Doctors must consider both the long-term (30-year) and short-term (10-year) risks of an individual developing cardiovascular disease (CVD) before initiating medication therapy for stage 1 hypertension, or high blood pressure, according to new research released on Monday by the American Heart Association (AHA).
The research, published in the AHA’s journal Hypertension, compared two tools for calculating cardiovascular disease risks. It showed that “if only the current 10-year risk thresholds are applied, fewer adults may be recommended for blood pressure-lowering medication.”
The team from the University of Alabama compared the predicted risks estimated by the AHA’s PREVENT risk calculator, released in 2023, to the previous tool for risk prediction called the Pooled Cohort Equations (PCE).
PREVENT uses sex-specific equations, incorporates markers of kidney disease in addition to HbA1c measures to help monitor metabolic health, and can estimate 10-year and 30-year risks for heart attack or stroke, as well as heart failure. It also considers additional risk factors with the social deprivation index.
On the other hand, the PCE does not calculate 30-year risk and also does not include heart failure or additional risk factor predictors such as kidney function or statin use. This comparison highlights the advancements in the PREVENT tool, which provides a more comprehensive assessment of an individual’s long-term cardiovascular risk.
“Many people 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 lead author Paul Muntner, a visiting professor in the department of epidemiology at the University. This underscores the importance of considering long-term risk in clinical decision-making.
This approach may also benefit people with no immediate risk, allowing them to start anti-hypertensive medication to prevent a heart attack or stroke event later in life. Early medication intervention could significantly reduce the long-term incidence of cardiovascular disease and improve public health outcomes. The findings suggest that a shift in focus towards long-term risk assessment could lead to better prevention strategies and ultimately save more lives.
By adopting the PREVENT tool, healthcare providers can offer more personalized treatment plans that address both immediate and future risks, ensuring comprehensive care for patients with hypertension.
