White Coat Black Art·DR. GOLDMAN'S BLOG

Take a quick online test to discover your risk of heart attack or stroke

@NightshiftMD found out he needs to eat a lot more carrots and cut down on the potatoes.
Researchers from the Ottawa Hospital and the Ontario-based non-profit health research Institute for Clinical Evaluative Sciences used big data to develop 'risk-prediction algorithms' for cardiovascular disease. (Shutterstock)

Heart disease is Canada's leading cause of death, but you can reduce your risk by living a wholesome lifestyle — that is, if you know what things you need to fix.

A new online calculator at Project Big Life helps Canadians measure the health of the old ticker by plugging in information about their risk factors for a heart attack or stroke. The mission of the website is to engage people and organizations by providing meaningful health risk information.

You input your age, smoking history, alcohol use, diet, level of physical activity and whether or not you have diabetes and high blood pressure, among other things.

The calculator gives you your percentage risk of having a heart attack or stroke within the next five years.

If your risk is five per cent, for instance, it means that five out of every 100 people with the same score (and therefore the same risk profile for heart disease) will have a heart attack or stroke over the next five years.

Five per cent is about as low a risk as you can get. If your risk is 50 per cent, it means your chances of having a heart attack or stroke in the next five years are one in two. The calculator also tells you your "heart age," and there is another calculator for life expentancy.

My biggest risk is my diet

I took the tests and discovered that I have a life expectancy of 86.8 years, and that my biggest risk factor is my diet.

My five-year stroke risk is 1.87 per cent. My heart age is around four years younger than my chronological age, but my vascular age is actually a year older. 

In a study published Monday in the Canadian Medical Association Journal, researchers from the Ottawa Hospital and the Ontario-based non-profit health research Institute for Clinical Evaluative Sciences explain how they used big data to develop "risk-prediction algorithms."

They compiled data from more than 104,000 Ontario residents that were part of Statistics Canada's population health surveys conducted in the years 2001 to 2007. They found the calculator "can accurately discriminate cardiovascular disease risk for a wide range of health profiles without the aid of clinical measures."

The researchers found that the calculator can be completed by lay people because it asks questions anyone can answer without having to visit the doctor to get a blood pressure reading or cholesterol level. Other studies have validated the calculator.

Dr. Doug Manuel from The Ottawa Hospital says a new online calculator can predict a person's chance of stroke. (The Ottawa Hospital)

The downsides of self-assessment

Every self-assessment score like this one has downsides. One issue is that the heart risk is based on information supplied by patients. If they get it wrong, the numbers could be way off. And, as mentioned, the calculation of your heart age and prognosis are not based on objective data such as your average blood pressure, your blood sugar or your cholesterol and triglyceride levels.

I have to admit it's a bit disconcerting to read predictions like that in large, bold figures on a computer screen.- Dr. Brian Goldman

Still, the authors of the study say the risk calculator is reliable at distinguishing who is likely to have a heart attack or stroke in the next five years and who may rest easy. Other studies have also found that chronic diseases can be accurately assessed by what the patient says about their health.

One issue I have is that the health calculator didn't ask how long my parents lived. My dad lived to be 92 years of age, and my mum lived to be 89. That has to nullify at least some of my bad dietary habits.

I have to admit it's a bit disconcerting to read predictions like that in large, bold figures on a computer screen. The best part about Project Big Life is that it allows you to see how much longer you might live with tweaks to your lifestyle.

In my case, I do enough vigorous exercise, but I should incorporate more moderate exercise into my daily routine by using my car less and by walking more.

And at my house, we're upping the intake of salads and carrots and cutting back on the potatoes. We wouldn't be doing that if I hadn't taken the test.


Dr. Brian Goldman is a veteran ER physician and an award-winning medical reporter. As host of CBC Radio’s White Coat, Black Art, he uses his proven knack for making sense of medical bafflegab to show listeners what really goes on at hospitals and clinics. He is the author of The Night Shift and The Power of Kindness: Why Empathy is Essential in Everyday Life.