Heart Risk Calculators Are Not Foolproof

The calculators that doctors use to estimate their patients’ future risk of heart attack are often off the mark, one study suggests.

The study, published in 2015 in the Annals of Internal Medicine, examined the performance of five widely used risk calculators, including the one unveiled in 2013 by the American College of Cardiology/American Heart Association.

It found that overall, four of the five calculators overestimated people’s risk by anywhere from 8 percent to 154 percent. The fifth calculator—the Reynolds Risk Score—overestimated the risk by a small amount in men; on the other hand, it underestimated women’s risk by 21 percent.

In general, risk calculators give an idea of your odds of suffering cardiovascular complications over the next decade—based on factors like age, blood pressure, cholesterol, diabetes, and smoking habits. Doctors use them to help decide whether a patient needs preventive therapy—with a statin or aspirin, for example.

Bottom line

Risk calculators are only a starting point—especially when your score lands you in a gray zone of “intermediate risk.” In such cases, it’s important for you and your doctor to weigh other risk factors, too, such as obesity or a strong family history of heart disease.

You might also benefit from computed tomography screening to look for calcium deposits in the coronary arteries. Calculators are useful tools, but they do not tell the whole story.