Updates to the AHA’s Cardiovascular Disease Risk Calculator, with Michael Shlipak, MD, MPH

The risk factors for cardiovascular disease, such as diabetes, smoking, dyslipidemia, and high blood pressure, have long been recognized. However, a recent development is the acknowledgment of chronic kidney disease as a significant risk factor for cardiovascular issues. This recognition is reflected in the new cardiovascular risk equation from the American Heart Association, which now incorporates kidney function and damage through albuminuria into its components.

In an interview with HCPLive,Michael Shlipak, MD, MPH, associate chief of medicine for research at the San Francisco VA Medical Center and a professor of medicine at the University of California, San Francisco School of Medicine, discusses his National Kidney Foundation (NKF) 2024 Spring Clinical Meeting presentation on the updated American Heart Association’s cardiovascular disease risk calculator.

While family history is widely acknowledged as a risk factor for cardiovascular disease, modern genetic studies have enabled the development of genetic risk scores. These scores contribute to understanding cardiovascular risk, although they do not account for a significant portion of it. His session highlighted the importance of the new cardiovascular risk equation, particularly in primary care settings, where physicians utilize cardiovascular risk assessment tools to determine appropriate preventive therapies for patients, such as statins or aspirin.

The updated risk equation offers several advantages over its predecessor, including a larger population size and broader diversity in age and ethnicity. Notably, it excludes race and instead utilizes a social deprivation index to capture environmental factors. Additionally, the incorporation of kidney function measures, such as estimated glomerular filtration rate (eGFR) and albuminuria, as well as heart failure as an outcome, enhances its predictive accuracy and relevance, especially for individuals with kidney disease.

Shlipak explains although the new risk calculator represents a significant advancement, there are considerations to address, such as individuals with extreme family history of cardiovascular disease and the need for further validation in different geographic settings. Moreover, he emphasizes the importance of routine kidney testing, particularly urine albumin tests, in primary care settings is crucial for early detection and management of kidney disease and for predicting cardiovascular risk accurately.

Disclosures: Shlipak has participated in advisory boards for Beyer, Boehringer Ingelheim, and AstraZeneca. He receives research funding from Beyer.