Future heart attacks may be better prevented in people who visit their GP with unexplained chest pain after researchers we funded have produced the clearest picture yet of factors that increase the risk of heart attack.
It’s estimated that at least one million adults in the UK visit their GP with chest pain every year. Despite undergoing tests, many go undiagnosed as the cause is unknown. Research has shown that people with this type of ‘unexplained’ chest pain are at higher risk of developing heart disease in the future than those without it, yet very few seek preventative treatment.
Now, researchers from Kiel University have identified the main risk factors that increase the likelihood of people with unexplained chest pain developing heart and circulatory diseases. The study is published in the European Journal of Preventive Cardiology.
The researchers hope that their findings will help doctors identify those most at risk so they can offer preventative treatments such as statins and lifestyle advice to head off future health problems, like heart attacks, before they occur.
Identifying people at risk
Researchers have developed a risk calculator that can identify people who are at high risk of developing heart and circulatory disease in the future and pinpoint the main factors that influence that risk.
The tools were developed and validated using anonymized information from the health records of more than 600,000 people registered with general practices in England with unexplained chest pain between 2002 and 2018. All records used were linked to hospital and mortality data, allowing researchers to track which patients were hospitalized or died from cardiovascular disease. The median follow-up period was at least five years.
The results showed that people with diabetes, atrial fibrillation (a common type of irregular heartbeat), and those receiving treatment for high blood pressure were at highest risk of developing heart and circulatory diseases.
A major opportunity for prevention
Nearly half of those at highest risk were smokers or obese. Modelling showed that if all obese smokers were helped to lose weight and quit, the average 10-year risk for this group would fall from nearly 22% to around 16%.
The study also suggests that GPs should be cautious in using current risk prediction tools, as they show they underestimate risk in this group.When the team compared their model with the existing QRISK3 risk calculator, they found that a third of patients who had a 10-year risk of less than 10% according to QRISK3 had a risk of more than 10% with the new model.
While further research is needed before the risk calculator can be used by physicians, the researchers say their findings highlight an important opportunity to identify people who are at highest risk of future heart and circulatory disease, helping both doctors and patients act earlier to prevent these diseases from occurring.
“More important than ever”
Our chief scientific and medical officer, Professor Brian Williams, said: “Using health data in research helps us address some of the biggest challenges in healthcare. By creating the clearest picture yet of factors that may put some people with unexplained chest pain at greater risk, this study has the potential to help more people avoid future heart disease.”
“At a time when the NHS is under extraordinary pressure, it is more important than ever that we respond to early warning signs to prevent inevitable heart attacks and keep people healthy.”
The success of our research
