In the United States, heart disease remains the leading cause of death, with someone suffering a heart attack every 40 seconds.
This makes screening to detect the risk of future heart attacks vital.
However, new research is revealing that there is a significant problem with our current heart health screening tools, which is leaving far too many of us at risk for an unforeseen attack.
In fact, researchers say the problem is so bad that the screening tools doctors are using right now miss nearly half of all heart attacks that occur just two days after the test.
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The usual suspects in heart health screening
According to researchers at the Icahn School of Medicine at Mount Sinai, there are two commonly used heart health screening tools: the Atherosclerotic Cardiovascular Disease (ASCVD) score and the Predicting Risk of Cardiovascular Disease Events (PREVENT) score.
These tools measure factors linked to the development of cardiovascular disease. These include factors such as your blood pressure, cholesterol, age, sex and race.
If your score exceeds a certain threshold, you’re considered at intermediate or high risk of heart attack (20 percent or higher chance of an incident over the next decade), you’re generally monitored and put on preventative measures to reduce your risks.
However, it seems these tools have been failing to effectively identify who is likely to have a heart attack.
As Mount Sinai researcher, Anna Mueller notes, “When we look at heart attacks and trace them backwards, most heart attacks occur in patients in the low or intermediate risk groups.”
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Failure to reflect true risk
In fact, when the researchers looked deeply into the health records of 465 people 65 years or younger who had been treated for their first heart attack, the results were grim.
The team found that just 2 days before their attack, ASCVD scores would have placed 45 percent of them in the low or borderline risk level!
And the ASCVD score wasn’t the only screening failure…
PREVENT scores were even less likely to accurately predict heart attack risk, placing 61 percent of patients at low or borderline risk just 48 hours prior to their first attack.
“Our research shows that population-based risk tools often fail to reflect the true risk for many individual patients,” says researcher and cardiologist Amir Ahmadi.
“If we had seen these patients just two days before their heart attack, nearly half would not have been recommended for further testing or preventive therapy guided by current risk estimate scores and guidelines.”
The researchers also found that the scores seem to miss people who don’t present with typical heart disease symptoms or risk factors.
“This study suggests that the current approach of relying on risk scores and symptoms as primary gatekeepers for prevention is not optimal,” says Ahmadi.
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Where does this leave us?
The researchers suggest that testing for signs of atherosclerosis may be more effective for assessing heart attack risk in groups without obvious signs.
That may include EKG, Echocardiogram, Stress tests, Nuclear Imaging, or simply the Ankle-brachial index (ABI), which compares blood pressure in your leg with that in your arm to help detect vascular disease.
It’s also critical to know the lesser-known signs of a heart attack…
Per Ahmadi, “This study highlights that a lower risk score, along with not having classic heart attack symptoms like chest pain or shortness of breath, which is common, is no guarantee of safety on an individual level.”
Previous research has revealed less obvious signs leading up to a heart attack that are easy to overlook. They include:
Heart attacks may also be more likely when:
Also, be aware of the combination of health conditions that make up Metabolic Syndrome (MetS), which significantly increases your risk for a heart attack.
You likely have metabolic syndrome if you’re affected by three or more of the following symptoms:
- Abdominal fat (high waist circumference)
- High blood pressure
- High blood sugar
- High blood triglycerides, which can raise your levels of LDL, or “bad” cholesterol
- Low HDL, the “good” kind of cholesterol
If you see a doctor regularly, you likely know if you have MetS. But there are three at-home diagnostics you can perform if you’re curious.
The bottom line here is that we must make a heart-healthy lifestyle a priority — and listen to the signs, however subtle, that our bodies send. The medical community knows a lot. They just don’t have it all figured out yet.
Sources:
Nearly Half of All Heart Attacks May Be Missed by Current Screening Tools — ScienceAlert
Heart Disease Facts — CDC
Atherosclerosis Overview/Diagnostics — UMVhealth.org
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