Doctors must consider the long-term (30-year) as well as the short-term (10-year) risk of an individual developing cardiovascular disease (CVD) before beginning medication therapy for stage 1 hypertension, or high blood pressure, according to new research on Monday by the American Heart Association (AHA).
The research, published in the AHA’s journal Hypertension, made a comparison of two tools for calculating cardiovascular disease risks.
It showed that “if only the current 10-year risk thresholds are applied, fewer adults may be recommended for blood pressure-lowering medication.”
The team from the University of Alabama compared the predicted risks estimated by the AHA’s PREVENT risk calculator, released in 2023, to the previous tool for risk prediction called the Pooled Cohort Equations (PCE).
PREVENT uses sex-specific equations; incorporates markers of kidney disease in addition to HbA1c measures to help monitor metabolic health; can estimate 10-year and 30-year risk for heart attack or stroke as well as heart failure; and considers additional risk factors with the social deprivation index.
On the other hand, the PCE does not calculate 30-year risk and also does not include heart failure or additional risk factor predictors such as kidney function or statin use.
“Many people with stage 1 high blood pressure who are not likely to have a heart attack, stroke, or heart failure within the next 10 years may have a high risk over the next 30 years,” said lead author Paul Muntner, a visiting professor in the department of epidemiology at the University.
This may also benefit people with no risk or short-term risk and “start anti-hypertensive medication” to prevent a heart attack or stroke event later in life.