Heart health organizations release flawed calculator that drastically overestimates risks

(http://www.nytimes.com) Last week, the American Heart Association (AHA) and the American College of Cardiology (ACA) released new guidelines for lowering cholesterol in addition to an online calculator for determining patients' disease risks and treatment options. Though it seems well intended, the risk calculator drastically overestimates risks to the point that it could mislead millions more of otherwise healthy individuals to start taking statin drugs.

The AHA and ACA admit that the risk calculator is not perfect but say that it is a step forward for public health and that the guidelines say patients and doctors should discuss treatment options instead of just doing what the calculator suggests.

According to the New York Times:

Dr. Sidney Smith, the executive chairman of the guideline committee, said the associations would examine the flaws found in the calculator and determine if changes were needed. "We need to see if the concerns raised are substantive," he said in a telephone interview on Sunday. "Do there need to be changes?"

The problem was identified by Dr. Paul M. Ridker and Dr. Nancy Cook, two Harvard Medical School professors who first pointed out the issue when they were sent drafts of the guidelines last year. The professors' recommendations to change the calculator either didn't make it to the development team or were ignored, as the calculator continues to use old, outdated data from the 1990s.

Drs. Ridker and Cook tested the calculator and found that, depending on the population, it overpredicted risk by 75 to 150 percent. For example, a man with a 4 percent risk might be wrongly informed that he has an 8 percent risk. The guidelines advise treatment for those with more than a 7.5 percent risk, so based on these guidelines and this calculator, people might unnecessarily be given harmful statin drugs.

The calculator was also tested by other doctors who felt like it was untrustworthy. "Something is terribly wrong," Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic, said. "[Using the calculator's results,] your average healthy Joe gets treated, virtually every African-American man over 65 gets treated."

The risk calculator presents a very serious risk of increased overprescription of dangerous pharmaceuticals in vulnerable populations. Statin drugs have already been linked to memory loss, muscle pain, increased diabetes risk and artery calcification. This debacle could cause more people to experience those debilitating side effects while filling Big Pharma's pockets; however, it seems more likely to cause the American Heart Association and the American College of Cardiology to lose credibility.