Age best predicts heart diseaseAll over 55s should be treated
Age alone could be used to predict who is most likely to suffer from heart disease and in need of preventive treatment, experts have said.
A study carried out at Barts and The London Medical School used a mathematical model to compare two different screening methods to identify those at risk of heart disease in a theoretical population of 500,000 people.
The first method used screening by age alone, with everyone over the age of 55 offered preventive treatment, even if they were not at risk.
The second method took into account multiple risk factors for heart disease and stroke including cholesterol levels, blood pressure and whether someone smoked as well as their age and sex.
Both methods of screening had a detection rate of 84 per cent. The study authors said this was equivalent to correctly identifying 84 per cent of all the people in a population who will have a stroke or heart attack.
Age alone screening had a 24 per cent false positive rate, meaning that 24 per cent of people screened would receive preventive treatment even if they were healthy. This compared with a false positive rate of 21 per cent using the multiple risk factors method.
Wring in the journal PLoS ONE, the authors argued that screening by age alone would be as effective as the current method of screening for heart disease using a combination of blood tests and medical examinations. It would also be more cost-effective, and could prevent more than 100,000 heart attacks and strokes every year, they said.
Study leader Professor Sir Nicholas Wald, Director of the Wolfson Institute, said: "This study shows that age screening for future cardiovascular disease is simpler than current assessments, with a similar screening performance and cost effectiveness. It also avoids the need for blood tests and medical examinations.
With age screening all individuals above a specified age would be offered preventive treatment. Everyone would benefit because, for blood pressure and cholesterol, the lower the better.
"The policy of selecting people above a certain age is, in effect, selecting people at high risk. It recognises that age is by far the most important determinant of that risk with other factors adding little extra prognostic information.
"Prevention is better than measurement. Identifying people at high risk of cardiovascular disease needs to be greatly simplified, enabling people to obtain easy access to preventive treatment from nurses and pharmacists as well as from doctors."
However, the British Heart Foundation said that this method of screening would miss some people at risk of heart disease.
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: “This research shows similar results to other more detailed risk assessments in an older population. But vitally it would miss younger people in higher risk groups such as those with a family history of heart disease, people of South Asian origin and people with diabetes.
“Because this model is cheaper it may be useful for a widespread screening programme. But it’s essential that we continue full risk assessments for younger people who may be at significant risk of getting heart and circulatory disease.
“Recognising and treating other risk factors such as high cholesterol and high blood pressure in people aged 40 to 55 could prevent them from developing heart and circulatory disease in the first place, which is the best outcome for them and makes economic sense for the NHS too.”
This article was published on Thu 5 May 2011
Image © Cecilia Lim - Fotolia.com
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