To estimate a patient’s risk of heart disease and stroke, many clinicians have used a tool called the Pooled Cohort Equations, which had separate equations for Black and White people. In recent years, concerns have grown that this approach may reinforce harmful stereotypes and suggest that race itself has a biological basis for disease. In this commentary, two cardiologists from the American Heart Association explain why the association’s new risk calculator, PREVENT, no longer uses race.
Instead of race, PREVENT considers factors such as kidney and metabolic health, which affect Black Americans more often, and a social deprivation index based on postcode, reflecting the social conditions that drive racial disparities in cardiovascular disease. It was developed and validated using data from more than 3 million people each, with diverse races and ethnicities and equal numbers of women and men, and proved accurate across all racial and ethnic groups studied. According to the authors, leaving race out also helps to make clear that race is associated with disease, but does not cause it.
The authors stress, however, that a more accurate calculator does not eliminate unconscious bias or the injustices that people of certain races and ethnicities face in healthcare. It is the effects of racism, not race itself, that are linked to disease risk. They describe PREVENT as a first step towards fairer tools in cardiovascular care, and note that research is under way to test whether it works equally well for everyone, regardless of how they identify, how much they earn or where they live.
Learn more here: https://newsroom.heart.org/news/race-racism-and-risk-prediction-for-cardiovascular-disease
Reference:
Churchwell, K., & Khan, S.S. (2024, March 12). Race, Racism, and Risk Prediction for Cardiovascular Disease. American Heart Association Newsroom.