Lisa Rapaport/Reuters Health
An online calculator may help young people predict their risk of developing heart disease in middle age – in time to make lifestyle changes to minimise their odds of a heart attack or stroke, a US study suggests.
For the study, researchers examined the accuracy of results from the free web-based Healthy Heart Tool. The online survey examines nine lifestyle factors that can influence the risk of heart disease: smoking, weight, exercise, and consumption of alcohol, fruits, vegetables, whole grains, nuts, sugary drinks, and red and processed meat.
It worked “moderately well” at predicting heart disease risk in a group of almost 5,000 adults who were followed for more than two decades, starting in their mid-20s, researchers report in JAMA Internal Medicine.
“It is not surprising that the factors in the Healthy Heart Score – diet, exercise, smoking, alcohol and body mass index – predict heart disease in the future,” said lead study author Dr Holly Gooding of Harvard Medical School and Brigham and Women’s Hospital in Boston.
“What is surprising is how well those lifestyle factors measured before the age of 30 years can predict the risk of heart disease, even in young adults without other risk factors for heart disease like hypertension, high cholesterol and diabetes,” Gooding said by e-mail.
Researchers tested the tool using 25 years of data collected from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Participants were 25 years old on average when they joined the study. Of the 4,893 participants, 427, or about 9%, had at least one clinical risk factor for heart disease such as high blood pressure, elevated cholesterol or diabetes.
Half of the individuals in the study were tracked for nearly three decades.
During the study, 64 women had a total of 69 heart disease-related events such as strokes or heart attacks, the study found. This translates into an annual risk of 0.9 events for every 1,000 women.
Over the same period, 99 men had a total of 104 events, for an annual risk of 1.75 for every 1,000 men.
At the start of the study, only about one in four people who went on to have a cardiac event had obvious risk factors like high blood pressure or diabetes.
But the group that had heart attacks and strokes had the worst average scores in the Healthy Heart Tool based on their lifestyle habits at the start of the study.
One limitation of the study is that with the exception of height and weight data used to calculate body mass index, all of the other factors assessed by the online tool were based on self-reported habits, not data objectively collected by clinicians, the authors note.
Researchers also assessed habits only once, at the start of the study, and it’s possible participants changed behaviours in ways that influenced their odds of a heart attack or stroke.
Even so, offering doctors and patients a way to see heart disease risk in relatively healthy and young adults may help people make lifestyle changes while there’s still a chance to significantly reduce their odds of a heart attack or stroke later in life, said Dr John Wilkins, a researcher at Northwestern University Feinberg School of Medicine in Chicago who wasn’t involved in the study.
The online tool offers feedback that encourages people to take action to improve poor habits, such as increasing exercise when activity levels or too low or cutting back on processed meat when consumption is too high. That feedback might help people take action early in adulthood when they’re not too set in their ways to change, Wilkins said in a phone interview.
“It pretty carefully helps you dissect your diet and your level of physical activity,” Wilkins said.
“Patients and clinicians aren’t particularly good at estimating their own risk,” Wilkins added. “This is one of the very few calculators that helps you estimate risk factors early in life, see how your health behaviours are associated with long-term risk and what you might change.”