Millions May Have Been Prescribed the Wrong Heart Meds, Study Says

More than 11 million Americans may have received incorrect prescriptions for aspirin, statins and blood pressure medications to prevent a heart attack or stroke, according to a study by the Stanford University School of Medicine.

That's because the tool used to estimate a patient's risk of heart attack or stroke is based on outdated data, apparently off by as much as 20 percent, according to the study, published Monday in Annals of Internal Medicine.

"A lot has changed in terms of diets, environments and medical treatment since the 1940s,” senior author Dr. Sanjay Basu said in the press release that accompanied the study. “So, relying on our grandparents’ data to make our treatment choices is probably not the best idea.”

The problem was discovered when some doctors, including Basu, kept noticing that the current tool was failing to accurately predict risk in their patients, particularly if they were African American.

Because the calculator was built on older studies that lacked a sufficient sample of African-Americans, doctors may have in fact been underestimating the risks of heart attacks or strokes in those patients.

“So while many Americans were being recommended aggressive treatments that they may not have needed according to current guidelines, some Americans — particularly African-Americans — may have been given false reassurance and probably need to start treatment given our findings,” Basu said in the press release.

The study says that in many cases medications were over prescribed.

A CBS report describes the calculator's importance in developing preventive treatments:

Risk estimate tools predict the likelihood of a future heart attack or stroke in the next 10 years. Doctors use these tools to help them decide what treatment a patient needs, if any at all.

In response to the troubling findings, the team of researchers developed a new calculator, incorporating an updated list of risk factors. From a STAT news story:

To test their methods, the researchers created two models. In the first one, they updated the cohorts they used. The populations were more diverse racially and ethnically, and they also reflected factors that can’t necessarily be captured by blood tests. Nutrition, physical activity, or even secondhand smoke — which wasn’t recognized in the 1940s — can affect a person’s baseline risk for disease. That’s why risk calculators don’t stay accurate forever.

Some doctors, however, still question whether the updated calculator can accurately assess risks in communities of color.

Dr. Andrew DeFilippis and Patrick Trainor of the University of Louisville, Kentucky say the new calculator falls short in accounting for racial differences in risk factors.

“This question is timely because a growing Hispanic population and 40 percent increase in Asian-Americans account for more than half of the U. S. population growth between 2000 and 2019,” they said in an editorial published with the Stanford study. “We clearly need an accurate risk assessment tool for these growing American populations.”

The Stanford researchers say the newer tool will need to be updated with changing times.