1. What is the goal of this calculator?
The goal of this calculator is to help people understand their risks of a cardiac event and how much benefit they might stand to gain by taking pills to reduce their risks.
Many people think that their risk is larger than it actually is. In addition, many people think that medication can do more to lower their risk than it actually can.
2. There are lots of web based calculators of cardiovascular risk. What is unique about this one?
It is true that there are many web-based calculators out there. Even the best of these do not make a distinction between the risk a person can change and the risk that is directly related to age and gender.
This calculator shows how the risk associated with heart disease fits within the overall risks from other causes.
3. What is the source of funding for this calculator?
This calculator has been compiled by the Foundation for Informed Medical Decision Making. We are a non-profit organization dedicated to improving the quality of decisions made by people in collaboration with their physicians. We work on providing people with objective, unbiased information about conditions, treatments, and tests so that they can use this information along with their own personal perspectives to make the decision that is right for them. The Foundation, its employees and the experts who work with the Foundation do not accept any funding from drug or device manufacturers or any organization that has a financial interest in any particular approach to medical treatment.
4. Where did the information used to develop this calculator come from?
There are several sources of the information presented in this calculator.
The calculation of cardiac risk comes from the Framingham Heart Study. This was a study that collected information from over 5000 men and women for 12 years in order to examine who developed cardiovascular disease and why. This information was then used to develop a mathematical formula that predicted the chance of developing cardiovascular disease or having heart-related events or deaths during the next 10 years based on a set of risk factors, including age, gender, cholesterol, blood pressure and smoking.
The estimates of benefit a person might attain by taking aspirin, or pills to lower either cholesterol or blood pressure, come from large randomized-controlled trials or meta-analyses of large trials with these medications.
The overall risks of dying in the next 10 years come from the Center for Disease Control's National Center for Health Statistics. These statistics reflect the average risk for a person of your age and sex; they do not factor in whether the person might be predicted to be of higher or lower than average risk based on the risk factors used for predicting a person's risk of developing cardiovascular disease.
5. Why isn't there more here about the benefits of various foods, nutrients, exercise, or other lifestyle changes that are so commonly reported about in the news?
There are several reasons why this calculator does not include precise information about the potential effects of lifestyle changes on a person's risk of cardiovascular disease.
The first is that these benefits likely work through modifying the risk factors that are entered in the beginning for the calculation of a person's cardiac risk. This means that improvements to diet or activity level affect blood pressure, cholesterol, or both. In addition, there are not strong data on the amount of benefit that a person might gain by making lifestyle changes.
Further, the amount of benefit a person can gain from diet and exercise depends on how much of a change is involved. For example, a person who does a lot of aerobic activity on a regular basis is likely to get little or no benefit in terms of cardiac risk from adding more aerobic activity.
The same can be said for dietary changes. For example, adding more fruits and vegetables to a diet rich in fruits and vegetables is likely to result in little change in cardiovascular risk. And the benefit of addition fruits and vegetables to a diet that contains few of these likely comes both from the added fruits and vegetables and from the reduction in intake of the foods they are replacing, making calculation of net benefit very hard to calculate reliably.
6. Can everyone take aspirin?
People who are allergic to aspirin, have an asthmatic reaction to aspirin, already take aspirin daily, take blood-thinning medication, have a bleeding disorder, peptic ulcer, liver disease or kidney disease should not take aspirin without consulting with their clinician.
7. What happens if I chose to take more than one kind of pill to lower my cardiovascular risk?
Persons who choose to take more than one kind of pill - say a pill to lower their cholesterol and a pill to lower their blood pressure-- will decrease their risk more than if they took only one type of pill. However, the benefits are not additive; that is, they will not get as large a decrease in risk from adding the second pill as they will if it is the only one they were taking.
8. Why should I care about the perspective on risk that the site provides?
Information about a person's risk and about the potential benefit of treatments are often presented in a framework that implies that all risk is to be avoided and that any benefit is something to go after. However, medical decisions are rarely that clean cut. There are pros and cons to every intervention. In order to make an informed decision about doing something to change one's risk, it is important to know how large the risk is and the amount of benefit the change might result in.
It is our contention that no one medical answer is right for all people, The decision about taking medication to reduce heart risks that will best serve a particular person depends critically on a person understanding risks and benefits in the context of other health risks and applying the person's own preferences and values to that understanding.
|
