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11 million may be taking the wrong drugs for heart health

More than 11 million Americans may have incorrect prescriptions for aspirin, statins, and blood pressure medications, according to a new study.

Researchers based their findings on an updated set of calculations—known as pooled cohort equations, or PCEs—used to determine the risk of a heart attack or stroke.

The PCEs are the foundation for cardiovascular-disease-prevention guidelines in the United States. They help physicians decide whether to prescribe aspirin, blood pressure, or statin medications, or some combination of these, by estimating the risk a patient may have for a heart attack or stroke.

Most physicians calculate a patient’s risk using a PCE web calculator or a smartphone app; the equations are also built into many electronic health records so that a patient’s risk is automatically calculated during an office visit.

But there has been debate over whether the PCEs are based on outdated data and therefore putting some patients at risk for over- or under-medication.

“We found that there are probably at least two major ways to improve the 2013 equations,” says Sanjay Basu, assistant professor of primary care outcomes research at the School of Medicine at Stanford University and a core faculty member at Stanford Health Policy. “The first was well-known: that the data used to derive the equations could be updated.”

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