Testing times

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Testing times

Public Health England’s online Heart Age Test sparked debate when it launched in September. So is it a useful tool or will it cause more harm than good?

The aim of the Public Health England (PHE) online Heart Age Test, which was developed in collaboration with the British Heart Foundation and University College London, is to provide people with information on their risk of cardiovascular disease (CVD).

But, is it a useful tool to remind people to make healthier choices, or is it a gimmick that has potential to cause distress resulting in increased demand for GP appointments? TMasked four pharmacy professionals for their thoughts. Here’s what they had to say…

Darren Powell, pharmacist

Ask anyone what their body mass index (BMI) is and I’m sure they will be able to quote it back to you, even if they don’t appreciate what impact it may have on their health or life expectancy. But the point is, BMI as a concept has become normalised with the general public.

It’s these simple ideas and concepts that stick in the mind and can help capture interest in an individual’s own health and wellbeing. I’m all for generating discussions around health — we need to increase the opportunity to do this in pharmacy and any other healthcare setting.

We know that cardiovascular disease is responsible for one in four premature deaths, so encouraging anyone over the age of 30 to answer the 16 questions [of the Heart Age Test] is surely a no-brainer? It’s an opportunity to have a discussion around cardiovascular risk, and I’m all for having those conversations.

In a number of the pharmacies I work in, we have the facility to measure blood pressure (some can even detect atrial fibrillation), so we can help feed in to this PHE campaign. I was shocked to read that over half of the people taking the test didn’t know their own blood pressure. Again, this is something that the pharmacy team can address and provide advice on.

So yes, I’m all for the Heart Age Test — a simple concept, well delivered and it will catch the public’s imagination.

Neera Goel, pharmacist

I appreciate the fact that awareness is being raised about cardiovascular risk and heart health. As the daughter of a patient who suffered a myocardial infarction (and thankfully survived), I understand how distressing CVD can be for patients and their families. Prevention is better than treatment and if you can change your lifestyle earlier on, the better the condition of the heart, in my opinion.

However, I do believe the test is in its infancy. The questions do not take into consideration lifestyle, such as exercise or diet, as much as they should. Stress has also been omitted. It does try to engage patients into thinking more about whether they should be taking better care of their heart. I have attempted to use it myself and unfortunately I received no response, it just said ‘still calculating’. This I can see causing unnecessary anxiety in some patients who may believe that its inability to produce a response is a bad sign. 

So, if the test could be developed further, it might become a useful tool in the future, but in its current format, I would not recommend it. It’s best for people to consult their friendly pharmacist to discuss any queries or concerns, or look at the British Heart Foundation website.

Natalie Davies, pharmacy technician

My first impression is that it is easy to use and navigate your way around. I noticed there were links underneath the questions which contained more detail – for example, a brief description of a medical condition and the national average for blood pressure readings – and I thought these were brief, informative and straight to the point.

Once I had answered my questions, I generated my heart age result, which came out as 32 years old (I’m 31 for those wondering). From here, I clicked on to the ‘About your calculation’ link and it gave me a list of personal results. Unfortunately I didn’t know my cholesterol level, so the national average was applied, however, it did state that my heart age was an estimate, which is good, so it should not cause patients anxiety. 

I scrolled down to ‘What affects your heart age?’ and I found this the most beneficial part of the test. The results tell you your BMI and if you are overweight, and offers advice on improving cholesterol and blood pressure if they are on the higher side, and how to become healthier. I particularly liked ‘Healthy eating to prevent heart disease’ section.

Overall I think the Heart Age Test is a good idea. It will hopefully make people more aware of how important their health is, how easy it is to find out these results and who to contact should they need help and advice. 

Ross Ferguson, pharmacist

Generally speaking, it’s useful for people to be aware of the risk factors for CVD and how they can mitigate those risks. However, in order to avoid getting a spurious result from this test, one really has to know their cholesterol level and blood pressure, otherwise it provides an overestimate of risk.

The tool has been lambasted by GPs who have voiced a number of concerns, including: it is inaccurate, there is a lack of evidence that this type of tool changes peoples’ behaviours, and that potentially it could drive further demand for GP services at a time when they are already over-stretched. 

Screening of this nature has to be targeted; it isn’t suitable for entire populations aged over 30. In fact, NICE advises that for the primary prevention of CVD in primary care, a systematic strategy should be used to identify people who are likely to be at high risk.

I don’t think the test is useful as the results are highly questionable, and it may be much better to have a targeted approach to assessing CVD risk and use community pharmacy to reach and assess these high-risk people.

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