New AHA Guidelines for Assessing Heart Disease Risk

American Heart Association heart attack and stroke risk assessment guidelines account for race and sex

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Knowing your heart disease risk can help you make lifestyle changes to avoid dangerous heart health problems. New guidelines from the American Heart Association (AHA) are meant to help doctors identify the patients who are most at risk.

A team of AHA doctors and medical experts looked at previous research to determine the age-, race- and sex-related risk factors for having a heart attack or stroke.

Previously, guidelines only assessed patients' risk for the next 10 years. These new recommendations may help doctors predict a patient's risk for their entire lifetime.

The guidelines committee suggested that knowing who is at high risk for heart disease will help doctors recognize who benefits the most from lifestyle changes and preventive treatment.

"Talk to your doctor about your heart disease risk."

David Goff, Jr., MD, PhD, and Donald Lloyd-Jones, MD, ScM, co-chaired the writing committee for the American Heart Association guidelines on the assessment of heart disease risk.

The guidelines were written to help identify patients who may have a high risk for developing atherosclerotic heart disease, a condition characterized by the hardening and shrinking of arteries.

Atherosclerotic heart disease prevents blood from flowing normally and can lead to heart attacks and strokes.

An American Heart Association committee, which included doctors and other medical professionals, reviewed research on heart disease risk in different populations in order to write the guidelines.

The guidelines include formulas based on race, sex and age for doctors to use to predict the risk a patient has of experiencing a heart disease related event within the next 10 years and in the patient's lifetime.

Certain risk factors, like smoking, high cholesterol and diabetes, have different effects on heart health for different genders or races. The new formulas account for the variances in risk factors.

The main difference in the updated guidelines, compared with those released in 2004, is the inclusion of stroke risk.

Previously, heart disease risk assessment only looked at coronary heart disease, or the buildup of plaque specifically in the heart.

According to the authors of the guidelines, accounting for strokes will help doctors more accurately assess heart disease risk, especially in populations who more commonly experience stroke, like women and African Americans.

Additionally, the committee assessed the helpfulness of new risk markers based on previous trials and studies. They noted that four markers seem especially useful if a person's risk of heart disease is uncertain.

The four new risk markers which could help doctors determine heart disease risk include the following:

  • A patient's family history of premature heart disease, or heart disease earlier in life than expected
  • A higher amount of calcium in the heart's arteries
  • Higher blood level of C-reactive proteins, which have been associated with heart attacks and strokes
  • The ratio of blood pressure in the ankle compared with blood pressure in the arm

The authors of the guidelines noted that there is a need for more research on risk assessment for different ethnic groups, ages and genders. They also noted that the accuracy of long-term and lifelong risk assessments should be examined.

The guidelines were published in Circulation and the Journal of the American College of Cardiology on November 12.

The research was funded by the American Heart Association and the American College of Cardiology. The authors did not disclose any conflicts of interest.

Review Date: 
November 12, 2013
Last Updated:
November 12, 2013