Over the past week, I’ve been inundated with calls from young friends and former patients panicked after taking the heart age test, and fearful they face an early death.
Despite many of these callers being “worried well”, they want to know whether they need to go to their GP to determine whether they will actually have a heart attack at the age the test predicts.
Public Health England (PHE) is encouraging everyone over the age of 30 to take the free online test, which calculates users’ heart age and life expectancy. If someone’s heart age is higher than their actual age, they are told by the test they are at an increased risk of having a heart attack or stroke. It also gives an age to which, on average, someone like them can expect to live without having a heart attack or stroke.
What is the evidence that this will provide any benefit for patients or public health?
The test claims to tell participants their true heart age – as opposed to their chronological age – by focusing on traditional risk factors for cardiovasular disease, including blood pressure and cholesterol numbers, and gives advice on how to reduce heart age. PHE claims that 80% of the nearly 2 million people who have already taken the test had a higher heart age.
Those who take the test and report abnormal blood pressure and cholesterol levels are advised to see a nurse or doctor at their GP surgery, visit a pharmacy, or take the NHS Health Check for 40 to 74-year-olds. Even those with no risk factors, but who do not know their blood pressure and cholesterol scores, are given the same advice.
I wonder what work GPs need to forego to do this pointless exercise.
As far as I know, PHE didn’t consult or discuss the test with professional organisations, including the British Medical Association.
GPs and their practice teams are already under immense pressure as they try to meet surging demand from a growing population, with a shrinking workforce and dwindling resources. If practices are now inundated with patients seeking advice after being understandably alarmed by the results from such a rudimentary test, they will find themselves stretched even more thinly, with less time and fewer resources to provide care to those presenting with immediate health concerns.
This is another example of general practice bearing the brunt of cuts to public health budgets, and follows reductions to behaviour change services, such as obesity prevention and stopping smoking support. Prevention is better than cure and if local initiatives to encourage healthier lifestyles were funded properly, then there would be no need for GPs to be the ones tasked with improving the population’s heart health.
Besides, not everyone is convinced cholesterol really is all that bad for your heart. An article in New Scientist states: “The cholesterol campaign is the greatest medical scandal in modern time. It’s certainly true that half of all heart attacks and strokes occur among apparently healthy people with normal or low levels of ‘bad’ low-density lipoprotein cholesterol.”
It’s more plausible that cholesterol is found at the scene of the crime for heart disease, but it’s not the perpetrator. As pointed out in the British Journal of Sports medicine by three cardiologists last year, the real cause of heart disease is inflammation. Sugar, refined carbohydrates, ultra processed food, sedentary lifestyle and chronic stress are the true culprits.
There is no evidence that PHE’s test has any reliability, and its own dietary guidelines have been brought under serious scrutiny.
PHE would do better to focus its efforts on more relevant methods of reducing risk of heart disease and stroke by reflecting the totality of evidence free of conflicts of interest. Until then, this test, the test results and the advice offered to those who take the test are all best ignored.