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The 2013 cardiovascular risk calculator overestimates the risk of a heart attack or stroke 5-6 fold!
Thursday, June 16, 2016 4:44 pm Email this article
The 2013 cardiovascular risk calculator which was put out by the American College of Cardiology and the American Heart Association overestimates the risk of a heart attack 5-6 fold in most people according to a study done by Kaiser Permanente Northern California.
Lies, lies and more lies from researchers paid by the drug companies to scare people into taking statins, which I believe are not only worthless, but dangerous. (If you have any doubt about this — that statins are not only worthless, but dangerous — see the articles about statins and cholesterol listed at the end of this article.)
It makes me want to vomit.
I no longer believe ANYTHING or ANYONE associated with the drug companies!
As I stated in 2014, I no longer believe drug studies or drug researchers paid by drug companies or guidelines or risk calculators or anything else that is associated with the drug companies in any way, shape or form.
This includes the American Heart Association and the American College of Cardiology.
Marcia Angell, MD, former editor at the New England Journal of Medicine: It is no longer possible to believe drug studies or key opinion leaders or medical guidelines (or risk calculators)
As Marcia Angell, MD, former editor at the New England Journal of Medicine for 21 years, wrote in 2009,
“It is simply no longer possible to believe much of the clinical research [ drug research ] that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines [ or risk calculators ].
“I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades [ 21 years ] as an editor of The New England Journal of Medicine.”
— Marcia Angell, MD, “Drug Companies & Doctors: A Story of Corruption,” New York Review of Books, Jan 15, 2009
The press release for the says:
A widely recommended risk calculator for predicting a person’s chance of experiencing a cardiovascular disease event—such as heart attack, ischemic stroke or dying from coronary artery disease—has been found to substantially overestimate the actual five-year risk in adults overall and across all sociodemographic subgroups. The study by Kaiser Permanente was published today in the Journal of the American College of Cardiology. ...
The actual incidence of atherosclerotic cardiovascular disease events over five years was substantially lower than the predicted risk in each category of the ACC/AHA Pooled Cohort equation:
- For predicted risk less than 2.5 percent, actual incidence was 0.2 percent
- For predicted risk between 2.5 and 3.74 percent, actual incidence was 0.65 percent
- For predicted risk between 3.75 and 4.99 percent, actual incidence was 0.9 percent
- For predicted risk equal to or greater than 5 percent, actual incidence was 1.85 percent
“From a relative standpoint, the overestimation is approximately five- to six-fold,” explained Dr. Go. “Translating this, it would mean that we would be over-treating a good many people based on the risk calculator.”
The study followed a population of 307,591 men and women aged 40 to 75 years old, including non-Hispanic whites, non-Hispanic blacks, Asian, Pacific Islanders and Hispanics, from 2008 through 2013 and had complete five-year follow-up. The study population did not include patients with diabetes, prior atherosclerotic cardiovascular disease, or prior use of lipid-lowering therapy such as statins.
To determine whether the risk equation might be improved by being recalibrated in “real world” clinical care, Kaiser Permanente researchers examined a large, multi-ethnic, community-based population of the health plan’s members in Northern California whose cholesterol levels and other clinical measures could theoretically trigger a discussion about whether to consider starting cholesterol-lowering therapy based on estimated risk using the ACC/AHA Pooled Cohort tool.
Among both men and women, there was consistent overestimation of observed five-year atherosclerotic cardiovascular disease incidence in each predicted risk category, with similarly poor calibration in both genders. Researchers also found consistent overestimation of actual atherosclerotic cardiovascular disease risk in each of the major ethnic subgroups. Results were also similar across measures of socioeconomic status.
Rana JS, Tabada GH, Solomon MD, Lo JC, Jaffe MG, Sung SH, Ballantyne CM, and Go AS. Accuracy of the Atherosclerotic Cardiovascular Risk Equation in a Large Contemporary, Multiethnic Population. J Am Coll Cardiol, 2016 May 10; 67(18): 2118-2130.
Author’s Contact Info
Alan S. Go, MD
Division of Research
Kaiser Permanente Northern California
Oakland, California 94612-2304 USA
The Press Release about the paper is posted here.
The paper is available for free here (in case you want to send a copy to your doctor).
Some articles about statins
Articles on the same subject can be found here:
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