Lifelong medication may not be necessary for all patients at risk for heart disease, based on a study that used simple markers of health to better estimate cardiovascular risk.
Published in the American Heart Association journal Circulation, this study looked beyond traditional risk factors when assessing risk for heart disease. According to researchers, well-established risk factors like high blood pressure and diabetes are important for identifying patients at high risk for heart disease. However, they may only provide part of the picture when it comes to heart health.
To better assess cardiovascular risk, researchers looked at 13 health markers associated with heart disease. These ranged from a marker of inflammation called C-reactive protein to the build-up of calcium in the heart’s arteries called coronary artery calcium. Researchers also considered factors like family history of heart disease and healthy lifestyle in estimating cardiovascular risk.
But rather than seeking out risk factors, researchers were more interested in how lacking these negative health markers impacts overall heart disease risk. For example, could having clear arteries offset increased heart risks associated with traditional risk factors like high blood pressure?
In total, researchers analyzed data from more than 6,800 U.S. adults participating in the MESA study (Multi-Ethnic Study of Atherosclerosis). Participants were free of heart disease at the start of the study and were followed up to ten years for key outcomes like heart attack and stroke.
After analysis, researchers found that taking into account additional health markers had a big influence on overall cardiovascular risk. Regardless of traditional risk factors, participants with no coronary artery calcium were 46% less likely to suffer heart attack, stroke and death than those with calcium build-up. Patients with less thickening of the arteries and fewer signs of inflammation also had lower risk for heart attack than those with these negative markers. Also, patients with no family history of heart disease had 19% lower risk for heart attack, stroke and death than those with a family history.
As authors explain, findings highlight the importance of looking beyond traditional risk factors in assessing cardiovascular risk. Combined with well-established risk factors, non-invasive tests like CT scans and blood tests can help provide a clearer picture of a patient’s health and risk for heart disease.
The goal of these tests, according to researchers, is to help avoid unnecessary medical treatment. However, it’s important that patients with any cardiovascular risk factors work with their doctors to determine their needs.