Heart Risk Evaluations

Invalidating Factors


The following factors make a heart risk analysis test invalid.

1.    Known risk factors not included in the test.

This is the number one reason that a heart risk analysis test would be invalid.  While this point seems overly obvious, the fact is that virtually every heart risk analysis test excludes several known risk factors, both minor and major.  For instance, the test used by the American Heart Association excludes triglycerides, second-hand smoke, angina, postmenopausal and stress levels.  If a factor is a known risk factor, it must be included in a valid heart risk analysis assessment.  All of the above mentioned factors are included in Heart Risk Evaluations.

2.    Simplification of categories

This is another one that seems so obvious, but all heart risk analysis tests fall victim to it.  What happens is that the test will include a certain risk factor, but handle it as a yes/no question rather than providing a number of categories.  For instance, the question may be asked, "Are you 20 or more pounds overweight?  y/n"  With these two choices, only one of two results can be returned.  This is very medically incorrect, because the results can be very misleading.  For instance, on this test the individual who is 19 pounds overweight will be given a much different score than one who is 20 pounds overweight, even though they are at virtually identical risk.  And the person who is 150 pounds overweight will be regarded the same as the one 20 pounds overweight.  This totally invalidates the test.  Many categories are often handled this way, including cholesterol, glucose, smoking and others.  (Is a chain smoker really at the same risk as one who smokes a couple of cigarettes a day?  Is someone whose systolic blood pressure is "borderline" 140 really at the same risk as someone whose is soaring at "extremely high" 190?  Of course not.   And yet, these are most often lumped into the same category.)  Furthermore, such inefficient handling of risk factors takes all motivation out of making improvements for the user.  One who is 100 pounds overweight must lose 81 pounds before they see improvement in their analysis report.  A simple look in the mirror or step on the scale tells them this is very wrong. They have worked hard and improved, and why isn't the test acknowledging this?  Heart Risk Evaluations breaks each risk factor down into several categories.  For body weight, for instance, there are over 10 categories.  Therefore, a loss of just a few pounds is rewarded with an improved test score.  Thus, the test matches the real life event.  Likewise is this true for blood pressure, waist measurement, smoking and the like.

3.    Improper handling of cholesterol and its components

Cholesterol is usually considered the number one factor in the development of coronary heart disease.  Billions of dollars have been spent on its research in connection with heart disease.  The Framingham Heart Study, as well as those in China, Helsinki and other locations have yielded tremendous volumes of detailed information regarding the relationship of total cholesterol, HDL cholesterol, and risk.  Sadly, and strangely, not one test implements this information into their program.

What these studies have clearly shown is that there is a strong relationship between total cholesterol, HDL cholesterol and risk.  How this works is rather simple.  When total cholesterol is low, at 150 or below, the development of heart disease is almost non-existent, regardless of the level of protective, or "good" HDL cholesterol.  At this low level there is just not much "bad" LDL cholesterol in the blood to cause damage by forming plaque.  As the level of total cholesterol begins to exceed 150 or 160, however, plaque can form and build in the arteries.  The savior here is HDL, and the higher the HDL levels the more protection offered.  As the total cholesterol level rises the levels of HDL become increasingly important.  So at a cholesterol level of 150, HDL is considered unimportant.  At total cholesterol 175 HDL levels regarding risk is slightly important.  At total cholesterol 190 HDL levels are important.  At total cholesterol 210 HDL levels are very important and at total cholesterol of 230 HDL levels are extremely important.  Thus the relationship between total cholesterol and HDL is established.  And again, this is a very important risk factor.

Yet, tests typically do not acknowledge this relationship.  Total cholesterol and HDL are handled as two separate categories.  (Some tests even ignore HDL completely.)  This creates huge discrepancies between test results and actual risk.  For instance, those with excellent lipid profiles of 150/35 are usually placed at higher risk than those with dangerous levels of 250/60.  This makes these programs totally invalid as potentially hazardous to the user.  The test by the American Heart Association offers only two choices for cholesterol and two for HDL.  A person with a cholesterol level of 150 is rated the same as one as at 239 (the cutoff point is 240).  At 150 one is almost guaranteed to never have a heart attack.  At 239 total cholesterol heart attacks are very, very common.  Likewise, the cutoff level for HDL is 35.  With a cholesterol level of, say, 210, an HDL of 35 is a lethal combination, while an HDL level of 80 is likely very safe.  

At Heart Risk Evaluations we make good use of the Framingham data and implement it into our test. Rather than two choices each for total cholesterol and HDL, making a combined 4 possibilities, we break both categories down into13 choices, for a combination of 169 possibilities.  Factoring in ten choices for triglycerides (another blood fat component), the combinations in our test equals 1,690; compared with the mere 4 offered in the AHA test.  So that the relationship between total cholesterol and HDL and triglycerides, very important risk factors are accurately reflected.



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