Online self-assessment of cardiovascular risk using the Joint British Societies (JBS3)-derived heart age tool: a descriptive study

Abstract

Objective: A modified version of the Joint British Societies (JBS3) 'heart age' tool was introduced online to broaden access to personalised risk assessment to the general population and encourage participation in the National Health Service (NHS) Health Check programme. This study reports on its early uptake and the profiles of those who used the self-assessment tool to determine their own cardiovascular risk.

Design: Observational, retrospective analysis of online tool use.

Setting: Between February and July 2015, user data collected from the NHS Choices website, where the tool was hosted, were analysed anonymously using standard analytic packages.

Results: The online tool landing page was viewed 1.4 million times in the first 5 months, with increased activity following limited media coverage. Of the 575 782 users completing the data journey with a valid 'heart age' result, their demographic and risk factor profiles broadly resembled the population of England, although both younger users and males (60%) were over-represented. Almost 50% and 79% did not know or enter their blood pressure or total cholesterol values, respectively. Estimated heart age was higher than chronological age for 79% of all users, and also for 69% of younger users under 40 years who are at low 10-year risk and not invited for NHS Health Checks.

Conclusions: These data suggest a high level of public interest in self-assessment of cardiovascular risk when an easily understood metric is used, although a large number of users lack awareness of their own risk factors. The heart age tool was accessed by a group not easily reached by conventional approaches yet is at high cardiovascular risk and would benefit most from early and sustained risk reduction. These are both important opportunities for interventions to educate and empower the public to manage better their cardiovascular risk and promote population-level prevention.

Keywords: Cardiovascular Prevention; Cardiovascular Risk; Digital health; Risk factors; Self Assessment.

Figure 1

Age and gender distribution by 10-year categories for users of the Heart Age tool that completed the user journey yielding a valid heart age.

Figure 2

Townsend profile of heart age tool users showing a similar distribution to that from Census data for England, suggesting good representativeness of the sample covering the full deprivation range. Comparison with lower LSOA based on Census 2011 and with deprivation profile of electoral wards (based on Census 2001). LSOA, layer super output areas.

Figure 3

Knowledge gaps in key risk factor numbers.(A and B) Proportion by age and gender groups, who knew their total cholesterol and blood pressure numbers; (C) proportion who knew their risk factor numbers individually and in combination.

Figure 4

Prevalence of other medical conditions by self-reported ethnic categories. BP, blood pressure; CVD, cardiovascular disease.

Figure 5

Heart age estimates with proportions who are older than their heart age, by age group of users.