Note the risk factors they used, and how they all include people receiving treatment for those risk factors:
- Blood Pressure: Systolic ≥ 120 mm Hg, diastolic ≥ 80 mm Hg, OR use of BP-lowering medication.
- Cholesterol: Total cholesterol ≥ 200 mg/dL OR lipid-lowering treatment.
- Glucose: Fasting glucose ≥ 100 mg/dL, diagnosis of diabetes, OR glucose-lowering treatment.
Why? 3 reasons, according to AI:
- If a person is taking medication to manage their blood pressure or cholesterol, it indicates that they have a physiological predisposition or a clinical diagnosis that requires intervention.
- Cardiovascular disease is typically the result of decades of exposure to nonoptimal levels of blood pressure or cholesterol. A person who currently has a “normal” blood pressure reading because they are taking an antihypertensive drug has still likely experienced significant periods of high blood pressure in the past. The study aimed to capture the antecedent occurrence (what happened before the event), and a prescription is proof of that history.
- The study sought to determine if CVD truly occurs in “low-risk” individuals. In clinical practice, a person taking a statin is not considered “low risk” simply because their current LDL cholesterol is low; they are categorized as a patient with a managed risk factor. By including treatment in their definitions, the researchers ensured they weren’t misclassifying treated patients as “healthy” or “risk-factor-free.”