Prescribe by Risk: The Utility of a Biomarker-Based Risk Calculation in Disease Management to Prevent Heart Disease

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Martin Root Ph.D, Associate Professor (Creator)
Appalachian State University (ASU )
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Abstract: Preventive treatment for those most at risk of heart disease rather than those with thehighest blood pressure or cholesterol values may be a more efficacious strategy fordisease man agreement. This depends on accurate biomarker-based risk assessmenttools. An evidence-based model of heart disease risk was developed using theFramingham model with an additional five risk factors, including three of the newerblood biomarkers. This was applied to the adult population of the 3rd National Healthand Nutrition Examination Survey cohort. Addition ally, the selection criteria fortherapeutic intervention from the Adult Treatment Panel III guidelines (forhyperlipidemia) and the 7th Report of the Joint National Committee (for hypertension)were applied to the same subjects. Of this cohort 54% qualified for at least one of thesemedications while 18% qualified for both. Using this 18% cutoff, the 18% of the subjects with the highest calculated heart disease risk were also identified using thedeveloped risk model. We applied established therapeutic reductions in heart diseaseprobability to those identified by guidelines and to those identified by risk. Applyingboth drugs to the high-risk group (one third the size of the guidelines group) achievedthe same reduction in population risk (about one fourth) as applying the drugs to theguideline groups and required only half as many prescriptions. Intermediate resultswere found when an intervention group was identified by a combination of both highrisk and high levels of risk factors. In this simulation, identifying patients by heartdisease risk level resulted in substantially fewer people being treated with fewer drugsand achieving a similar reduction in disease risk.

Additional Information

MARTIN ROOTand TIMOTHY SMITH(2005)Prescribe by Risk: The Utility of a Biomarker-Based Risk Calculation in Disease Management to Prevent Heart Disease. DISEASE MANAGEMENT (Volume 8, issue 2)
Language: English
Date: 2005
, Biomarker, disease, management, heart, disease,

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