Predicting Your Risk

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My Take:

This new calculator, known as the PREVENT calculator, is meant to replace the old cardiovascular disease risk calculator for predicting an individual’s risk of developing cardiovascular disease (CVD). It gives 10-year and 30-year risk estimates, and is meant for those who have not already had a cardiovascular event. (If you’ve had a heart attack or stroke, have heart failure, or needed a stent, for example, you’re already known to be high risk and do not need to use this calculator.)

I’ve used the new PREVENT calculator myself, and have found it to be more accurate than the old calculator. (PREVENT is a trademark of the American Heart Association and stands for “Predicting Risk of cardiovascular disease EVENTs.)

What’s different about this new calculator? Several characteristics stand out:

1) It includes new measures of cardiovascular disease, kidney disease, AND metabolic disease.

2) It includes broader measures of health and provides sex-specific results, but leaves out considerations of race.

3) It is based on data that include a variety of racial and ethnic, socioeconomic, and geographic backgrounds, and is not based only on “White” or “Black” identification of race. This opens it up to the entire population, and takes into account what are known as socioeconomic determinants of health—such as where a person lives and what healthy lifestyle factors are accessible in their environment.

4) It allows for calculations in younger persons. The prior calculator began at the age of 40, and was not accurate for those younger than that.

5) For the first time, this is a calculator that estimates risk for heart failure specifically, in addition to predicting risk for heart attack and stroke.

To use the new PREVENT calculator, you’ll need to know the following:

• Total cholesterol

• HDL (“good”) cholesterol

• Systolic blood pressure (top number)

• Body mass index (BMI)*

• Estimated glomerular filtration rate (eGFR)— a measure of kidney function, found on your routine chemistry lab results (the one that has sodium, postassium, glucose, etc.)

• Diabetes (yes or no; any history of diabetes)

• Current smoking (yes or no)

• Anti-hypertensive medication (yes or no; taking any med for blood pressure)

• Lipid-lowering medication (yes or no; taking any med for cholesterol)

• Optional: zip code, Hemoglobin A1c, urine-albumin creatinine ratio

*Yes, we know that BMI is an imperfect indicator of obesity, but that’s what is currently used in this calculator. I’m hoping they will add waist circumference or another better measure of obesity and metabolic risk to the next calculator.

Seem complicated? It does help to have your physician or other healthcare professional plug these numbers in for you, or at least point you to the correct lab results you can use in this calculator. Feel free to share this site with your physician: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator

My Take:

Heart disease is the leading cause of death for both men and women, but men tend to have heart disease occur earlier in their lives—as much as 10 years before women do.

Men also have specific risk factors that can serve as warning signs for heart disease, including erectile dysfunction and low testosterone (as we saw in last week’s newsletter). Check out the article above for a good rundown on these specific risks and warning signs in men.

And, to learn more about low testosterone:

My Take:

This sentence says it all: “An artificial sweetener known as sugar alcohol has never sounded like the healthiest thing for people. Turns out, it may not be.”

There have been a number of studies showing health harms from ingesting artificial sweeteners, including sugar alcohols like xylitol, and this is the latest one. As detailed in the article, Cleveland Clinic researchers found that consumption of higher levels of synthetic xylitol can increase risk of heart attack, stroke, and other cardiovascular events.

Synthetic xylitol is often found in manufactured food products such as chewing gum, as well as in candy, packaged desserts, and sweetened beverages labeled as “sugar-free,” “keto-friendly,” “diabetes-friendly,” or “calorie-free.”

One exception to this risk appears to be in oral care products such as toothpaste or mouthwash. According to one of the lead researchers, “We know that xylitol in your oral care products can help fight cavities. And since you don’t ingest those products in large amounts, they’re still OK to use.”

You can learn more about xylitol here:

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