What are patients and doctors to do? On Sunday, there seemed to be no firm answers, except that those at the highest risk, like people who have had a heart attack or have diabetes, should take statins. Peter Libby, the chairman of the department of cardiovascular medicine at Brigham and Women’s Hospital. “We’re surrounded by a real disaster in terms of credibility,” said Dr. Cook examined were unusually healthy and so their heart attack and stroke rates might be lower than expected.Īsked to comment on the situation on Sunday, some doctors said they worried that, with many people already leery of statins, the public would lose its trust in the guidelines or the heart associations. The chairmen of the guidelines panel said they believed the three populations Dr. Smith, who is also a professor of medicine at the University of North Carolina and a past president of the American Heart Association, “What we have come forward with represents the best efforts of people who have been working for five years.” Ridker “merit attention.”īut, he continued, “a lot of people put a lot of thought into how can we identify people who can benefit from therapy.” Further, said Dr. Smith of the guidelines committee said the concerns raised by Dr. Then they asked how many had heart attacks or strokes in the next 10 years and how many would the risk calculator predict.

They knew the subjects’ characteristics at the start - their ages, whether they smoked, their cholesterol levels, their blood pressures. Cook evaluated it using three large studies that involved thousands of people and continued for at least a decade. This week, after they saw the guidelines and the calculator, Dr. “The cohorts were from a different era,” Dr. And people get heart attacks and strokes at older ages. Among other things, there is no longer such a big gap between women’s risks and those of men at a given age.

For example, the guideline makers used data from studies in the 1990s to determine how various risk factors like cholesterol levels and blood pressure led to actual heart attacks and strokes over a decade of observation.īut people have changed in the past few decades, Dr. Blaha said the problem might have stemmed from the fact that the calculator uses as reference points data collected more than a decade ago, when more people smoked and had strokes and heart attacks earlier in life. Michael Blaha, director of clinical research at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins University, who was not associated with forming the new guidelines.ĭr. “I don’t think people have a good idea of what needs to be done,” said Dr. Other experts said there has not been a real appreciation of the difficulties with this and other risk calculators.

Ridker and Cook saw the final guidelines and risk calculator on Tuesday at 4 p.m., when a news embargo was lifted, and saw that the problems remained. Donald Lloyd-Jones, co-chairman of the guidelines task force and chairman of the department of preventive medicine at Northwestern University.ĭrs. That was unfortunate because the committee thought the researchers had been given the professors’ responses, said Dr. Both reported back that the calculator was not working among the populations it was tested on by the guideline makers. Nancy Cook, had pointed out the problems a year earlier when the National Institutes of Health’s National Heart, Lung, and Blood Institute, which originally was developing the guidelines, sent a draft to each professor independently to review. The problems were identified by two Harvard Medical School professors whose findings will be published Tuesday in a commentary in The Lancet, a major medical journal. “We need to see if the concerns raised are substantive,” he said in a telephone interview on Sunday. 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.

Heart health calculator