A new University of Florida study finds that 65 percent of African-American men over age 40 are at high risk of having a heart attack or stroke within the next 10 years. That percentage represents a substantial increase over time, from 53.5 percent in 1999. The findings appear in the American Journal of Preventive Medicine.
“Not only has this population shown a rise in risk, a significant majority of this group is at high risk for a 10-year major cardiovascular event. This is quite worrisome,” said lead investigator Dr. Arch G. Mainous III., chair of the department of health services research, management and policy in the University of Florida College of Public Health and Health Professions.
Dr. Mainous says the findings underscore the importance of prevention efforts targeted to African-American men, such as lowering their blood pressure and making lifestyle changes. Using tools that calculate heart disease risk scores can help identify people who could benefit from early interventions.
“The value of computing these risk scores is so we know who is at high risk and we can intervene,” he said. “It’s too late to wait until people have strokes.”
In 2013, the American College of Cardiology and the American Heart Association released the Atherosclerotic Cardiovascular Disease, or ASCVD, risk score. The ASCVD risk score uses weighted variables, including age, sex, race/ethnicity, smoking status, diabetes status, cholesterol, blood pressure and blood pressure medication status, to calculate individuals’ risk of having a heart attack or stroke within the next 10 years.
The UF study is the first to apply the tool on a population basis to identify groups, based on age, race and gender, that might be at high risk.
For the study, researchers analyzed data for the years 1999 to 2014 from the National Health and Nutrition Examination Survey, a nationally representative study that collects data from a combination of interviews, physical examinations and laboratory tests. They calculated the ASCVD risk score for participants ages 40 to 79 who did not have a previous diagnosis of coronary heart disease, stroke or heart attack.
A score of 7.5 percent or higher is considered high risk. The American College of Cardiology and the American Heart Association recommend drug therapy and lifestyle changes for people who score a 7.5 percent or higher risk of having a heart attack or stroke within 10 years.
The UF researchers found that non-Hispanic black men experienced a significant increase in risk during the 15-year period they examined, rising from 53.5 percent to 65 percent. In comparison, the prevalence of high cardiovascular disease risk among white men was 44.5 percent in 1999 and 48.2 percent in 2014.
Dr. Mainous said the ASCVD risk score should be better integrated into clinical practice. It is easy to use, available for free online and gives physicians an accurate assessment of risk without having to judge a patient’s risk based on their own calculation of individual risk factors.
“Using validated, multivariable risk scores in practice is the best way to understand your patient population and who is at risk,” Dr. Mainous said. “Physicians need to use these tools and patients need to know what their risk score is.”