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Medical Terminology for Healthcare Professions

(12 reviews)

Andrea M. Nelson, University of West Florida

Katherine Greene, University of West Florida

Copyright Year: 2021

Publisher: University of West Florida Pressbooks

Language: English

Formats Available

Conditions of use.

Learn more about reviews.

Reviewed by Carolina Molina-Martin, Adjunct Faculty, Old Dominion University on 6/16/24

This book is comprehensive and informative. In addition to a Table of Contents that provides a breakdown of each of the 18 chapters, a Glossary follows the Table of Contents. Glossary terms are bolded in green and their definitions can be found in... read more

Comprehensiveness rating: 5 see less

This book is comprehensive and informative. In addition to a Table of Contents that provides a breakdown of each of the 18 chapters, a Glossary follows the Table of Contents. Glossary terms are bolded in green and their definitions can be found in the glossary at the end of the book.

Content Accuracy rating: 5

The content is very accurate, . It is non biased, and inclusive. The chapters are very thorough and well-written. There are no glaring errors.

Relevance/Longevity rating: 5

The information presented in the text is relevant and is not information that will become outdated, as it is focused on medical terminology.

Clarity rating: 5

The book is written in very accessible language. Terms are presented with appropriate depth and clarity. Each chapter opens with a list of word parts (prefixes, combining forms, and suffixes) related to the topic. References are included with each chapter.

Consistency rating: 5

The terminology and framework are consistent, Interactive content is built into each chapter. The structure of each chapter is consistent throughout. It starts with learning objectives.

Modularity rating: 5

The book is easy to read. It is written with well defined chapters broken into manageable paragraphs.

Organization/Structure/Flow rating: 5

Extremely well organized. The order of presentation is overall logical and clear. Pertinent information for the topic of the chapter is covered.

Interface rating: 5

The interactive reinforcement activities require you to click, drag and drop, listen and repeat, flip, and test yourself. No issues were found with the features of the text. The interface is user-friendly, No problems with navigation.

Grammatical Errors rating: 5

No glaring errors.

Cultural Relevance rating: 5

The text is not culturally insensitive.

This OER book is different from many traditional medical terminology textbooks. Kudos to the authors for all of their hard work on creating such a wonderful book. This resource will serve well future healthcare students and any healthcare profession.

Reviewed by Judith Guetzow, Lecturer II, University of Texas Rio Grande Valley on 5/22/24

The text offers comprehensive coverage of medical terminology for healthcare professions, presenting terms with appropriate depth and clarity. Each chapter opens with a list of word parts (prefixes, combining forms, and suffixes) related to the... read more

The text offers comprehensive coverage of medical terminology for healthcare professions, presenting terms with appropriate depth and clarity. Each chapter opens with a list of word parts (prefixes, combining forms, and suffixes) related to the topic. Medical terms are prominently displayed in bold green font throughout the chapters, and a useful glossary is provided in the book, aiding students in quickly locating relevant vocabulary. Furthermore, at the end of each body system chapter, a vocabulary list is included, featuring terms associated with that specific system.

The content is accurate, error-free, unbiased, and reflects the latest developments in the field; thus, providing students with reliable information essential for their understanding of medical terminology.

The content is current, ensuring students learn terminology that reflects existing practices. The authors provide a balance between current information and the established principles of medical terminology, ensuring the text remains relevant without quickly becoming obsolete. Its structured format allows for easy updates as medical terminology evolves.

Written in clear and accessible prose, the text provides explanations and context for technical terms, making it suitable for students at all proficiency levels and enhancing overall clarity.

Consistency is maintained throughout the text in both terminology and framework; thus, contributing to its reliability and lucidity. This is conducive to improving students’ comprehension and retention of the medical terms.

The modularity of the text facilitates flexible teaching approaches. The text is organized into eighteen chapters that can be further divided into reduced sections, allowing instructors to assign smaller reading sections without disrupting the flow of the material.

The topics in the text are presented in a logical, clear fashion guiding students through progressively more complex concepts in a clear and discerning manner. As students advance through each body system, they learn the corresponding medical terms, the word parts that form these terms, and the relevant abbreviations specific to each system.

The interface of the textbook is user-friendly, free of significant navigation issues or display problems that could hinder the learning experience. There is a clear presentation of images and charts which enhances the learning experience. Each chapter integrates interactive content such as videos, flashcards, drag-and-drop exercises, and self-tests that are exclusive to the online format. Hyperlinks to the interactive content are provided to users of PDF or EPUB versions of the text. This content was accessible to a diverse range of learners, with closed captioning provided for the videos, and no errors were detected in the captions. Additionally, image descriptions were included for each picture. A minor concern is that certain flashcards lacked the text-to-speech feature.

No grammatical errors were found. The text is grammatically sound and written at a level appropriate for the students, ensuring readability.

The material is free from inappropriate or offensive content.

Overall, the authors created a comprehensive textbook that provides a thorough understanding of medical terminology relating to body systems and pathology, diagnostics, and medical procedures. It would be wonderful if PowerPoints, test banks, and assignments as learning exercises that require students to break down the terms into word parts were included in each chapter. However, I found reading the text and engaging with the interactive activities enjoyable. Reviewing this material has been valuable, as it has piqued my interest in potentially using it for my medical terminology class in the near future.

Reviewed by Gary McIlvain, Professor, Marshall University on 5/21/24

It covers the information very well. It tends to become an anatomy textbook too much. read more

It covers the information very well. It tends to become an anatomy textbook too much.

The accuracy was on par. Again, too much "anatomy book" context for med term.

With anatomy and medical terminology, it rarely changes. So, the text longevity would be good.

The ease of reading the text is great and students would be able to follow it well. It seems to become a better anatomy text than medical terminology or maybe the title should be "applied medical terminology" and it state it focuses on applying it within anatomy.

Yes, but more anatomy textbook than I would use for a med term class.

It is divided by systems, which is a common way to organize a medical terminology text.

It does do a good job applying it to common every day issues (e.g. M.S.)

Great use of drag and drop and flash cards.

I didn't note any errors.

Yes, it did use pictures that depicted varying racx3es, ethnicities, and backgrounds. It is limiting in anatomy pictures to be able to do this...

I would like to see basic pharmacology used in it. I would not currently use this as the only text due to the lack of basic pharmacology. With that added it would be a great text.

Reviewed by Jenni Johnson, Assistant Professor, Marshall University on 5/21/24

This book provides appropriate medical terminology for all regions of the body as well as all healthcare disciplines. It is a great asset for any healthcare profession. read more

This book provides appropriate medical terminology for all regions of the body as well as all healthcare disciplines. It is a great asset for any healthcare profession.

I found no mistakes within the textbook.

The book is extremely relevant and it can be utilized for many years across many healthcare professions. This text is also good for a variety of learning styles by utilizing virtual flash cards and videos with audio.

The textbook is clearly and concisely written

Each chapter follows the same format which makes it very easy to navigate.

This book has 18 chapters and they are clearly outlined. Each chapter is broken up into sections that have an excellent flow that builds learning over time.

Each area is clearly defined

Each chapter and learning tool is easy to navigate and there were no technical issues.

I found no grammatical errors in the text.

There was no cultural bias in this text. It was inclusive of all cultures, and genders and free from religious bias.

I believe this text can be used for a wide variety of future healthcare professions. The flashcards, interactive videos and end of chapter quizzes appeal to all learning styles and assist with retention. Each word is broken down to easily understand the meaning and use of the terminology,

Reviewed by Wendy Schuh, Assistant Professor, Minnesota State University Mankato on 2/8/24

This book is clearly laid out with 18 different chapters covering all of the body systems + obstetrics. There are interactive figures, flash cards, and end of chapter quizzes. Vocabulary words have a linked definition within the text. It would be... read more

This book is clearly laid out with 18 different chapters covering all of the body systems + obstetrics. There are interactive figures, flash cards, and end of chapter quizzes. Vocabulary words have a linked definition within the text. It would be an added benefit to include pronunciation, which is an important component of medical terminology. Videos have a captioning option.

No concerns with accuracy.

References are included with each chapter. Publication date is 2021, and most references are within the last five years. In addition, this content is mostly stable over the years. CrashCourse videos are a little older (2015) but many students are familiar with Hank Green in this format. Information is relevant and easy to process.

Clear chapter content, sections, and headings.

Consistent style of writing, activities, page layout, etc. throughout the book.

Chapters organized in a logical manner. Flashcards and interactive body part activities are wonderful tools, even better since they can be completed multiple times.

Organization/Structure/Flow rating: 4

The structure of the textbook is sound and consistent with other medical terminology textbooks. A more thorough Table of Contents would allow for easier navigation. It has a good balance of technical and non-technical writing that makes it easy to read and comprehend.

Interface rating: 3

Appealing and interactive. I attempted to take advantage of the “re-use” option below each activity but could not figure it out. Search function does not work well. I tried searching phrases directly from the text, and it would not pull up. The labeling activities were difficult to complete as the drag and drop feature would not scroll. Therefore, it would be useful to have a correct answer option to see the completed figure. It would be helpful to have descriptions included with different e-book options that explain interactive functions with each format.

Very clean and proofed!

Appeared to be culturally inclusive, although it is difficult to assess in this type of resource. No diverse representation of skin color on diagrams.

This is a great textbook that mimics other medical terminology textbooks costing $100+ that don’t have interactive components. There could be some great additions to more effectively use this for a course textbook, such as a question bank, study guides, and suggestions for worksheets and projects to incorporate points into a course framework.

Reviewed by Sharon Schaeffer, Associate Clinical Professor, Bowling Green State University on 4/16/23

Covers major body systems . read more

Covers major body systems .

I did not see any errors during my review.

Medical terminology is a pretty static topic. When students learn how to correctly combine forms, they will be ready to decipher new vocabulary that comes with progress in health care.

Easy to understand.

The depth of content is consistent.

I will allow students to choose their topic of the week after the first 3 chapters are complete. The module system will work well for this design. This design allows students taking A & P or similar courses the opportunity to learn med term at the same time as they are learning in other courses.

Well organized.

I had no challenges linking to and using the added features.

No problems noted.

Inclusive content.

This book will help my students learn the basics of medical terminology as a foundation for building a strong professional vocabulary. I like the interactive activities in this book as it helps learners of different styles. It would be a bonus if there were quiz question banks available. It is not enough of a deal breaker to stop me from using this in my course next Spring semester.

Reviewed by Kristin Meyer, Professor, Drake University on 12/15/22

The text comprehensively covers medical terms in each body system, with a couple of introductory chapters. It covers the span of life with a dedicated obstetrics chapter, which I have not seen in other texts. read more

The text comprehensively covers medical terms in each body system, with a couple of introductory chapters. It covers the span of life with a dedicated obstetrics chapter, which I have not seen in other texts.

No inaccuracies identified.

Medical terminology does not easily or often change, but the text could be easily updated from time to time to include new disease states or terms.

No issues with clarity identified.

Each chapter has a consistent format with link to video overview and active learning activities interspersed throughout.

The organization by body system allows an instructor to assign the appropriate amount of content to correspond with course credit hours.

The online version is easy to navigate. The search function doesn't work as I would expect it to.

Interface rating: 4

The online version is easy to navigate. The pdf download has none of the interactive features. It would be nice if the pdf version could somehow include the active learning exercises in each chapter, with an answer key appendix.

No grammatical errors identified.

Does not appear to be culturally insensitive.

I could easily adopt this text for my web-instructed undergraduate medical terminology class. The interactive features are helpful to engage students. A summary quiz at the end of each chapter would be a nice added feature.

Reviewed by Nancy Bouchard, Adjunct Professor, North Shore Community College on 11/14/22

Very well done. read more

Very well done.

Very accurate and not biased.

If updates are needed, they could be added with ease.

Well written text.

Very consistent.

Very user friendly. Easy to read and assign chapters.

Very organized.

I did not encounter any issues.

None noticed.

Not insensitive or offensive.

My only concern is for the student who has no prior exposure to medical terminology, healthcare training or will not have a clinical role in healthcare. I would not want them to get overwhelmed by the depth of detail in each chapter. I would suggest a section in each chapter that contains exercises for students to test their understanding of the subject matter read, practice correctly writing the terms and the like. Visual learning is only one way for students to absorb content. I would have to create ways to test their understanding to be graded using quizzes, a research project, midterm and final exam. I'm on the fence if the content in the textbook is too deep for only needing a basic understanding of medical terms.

Reviewed by Martha Fabian-Krause, Adjunct Clinical Instructor, Rogue Community College on 9/1/22

Systematic flow of each body system to include root word, prefix, suffix, anatomy, physiology, video and practice in each section. Logical to follow. read more

Systematic flow of each body system to include root word, prefix, suffix, anatomy, physiology, video and practice in each section. Logical to follow.

No issues noted. Very accurate.

Timeless interpretation of terminology would make the on line text need updating only if new medical information becomes available.

Detailed explanations of terminology, anatomy and physiology with pertinent examples and word practice at the end of each body system.

Each section is consistent by acknowledging medical diseases, disorders, and procedures related to the root words. Good follow through in each body system.

This on line book can be assigned in a particular order relevant to other class material and does not need to be completed in any particular time frame. Pleasurable reading.

The format of each section (body system) is in a progressive fashion and is put together with a video near the beginning and word games at the end of each section. Good sequencing noted throughout.

Charts are easy to navigate. There is an identical format what is easy to assimilate.

None noted.

No diversive issues noted. Represents the full spectrum of human anatomy and physiology.

Marvelous understanding of the root words, prefix, suffix and detailed anatomy and physiology. The videos and word matches at the end of each section put the meaning crystal clear.

Reviewed by Carla Tobin, Faculty, Century College on 6/17/22

This textbook covers all of the body systems, the word parts and rules, and prefixes and suffixes. read more

This textbook covers all of the body systems, the word parts and rules, and prefixes and suffixes.

This book is very accurate. No discrepancies or errors were noted in the textbook.

Medical terminology is a subject that does not change over the years. As new diseases and technologies arise, they can easily be incorporated into the content.

The language used in the book is clear and pronunciations of the terminology is provided throughout the e-book. This is an easy to read book for high school or college level students.

The chapters are consistent in there format and organization throughout the textbook. It is easy to follow for the student.

The chapters are broken down into sections which make it easy to read. The videos are shown within the textbook, so the user is not taken to another site. One suggestion would be to have a link to the next chapter at the bottom of the page rather than scrolling up to the top to choose the next chapter from the left side menu.

The organization of this textbook is exactly what you would expect for a Medical Terminology textbook. It is divided into chapters by body system.

There are no apparent issues with the interface. As noted above, the videos are shown within the textbook window, so the user is not taken to another site.

I did not note any grammatical errors in this textbook.

Cultural sensitivity is not really relevant with medical terminology. This language is used in many countries in order to be able to communicate in the same language.

I agree that the best use of this book in the online internet version. This is a very comprehensive medical terminology book. It covers all of the body systems and word building of medical terminology. The chapters provide many opportunities to practice what the student has learned. I liked that each chapter has the learning objectives listed at the beginning. I would have liked to see chapter summaries for the students to study. I think that this book could easily be incorporated into an online class, however, some work would be involved making PowerPoints, homework and quizzes. Overall, this is an excellent Medical Terminology book.

Reviewed by Renee Eaton, Advanced Instructor, Undergraduate Director, Virginia Tech on 5/17/22

Systems-based organization and includes all body systems. read more

Systems-based organization and includes all body systems.

No errors or issues noted

Medical terminology is something that rarely changes. Context activities may change over time, as does disease prevalence and knowledge, but new terms or different terms are not common.

Clear descriptions and use of technical and non-technical language.

The organization is the same across each chapter making the book easy to access and navigate. Language and flow are consistent.

Text is easy to navigate. It may be helpful to provide some in-chapter navigation on the lower menu bar. For example, the previous and next chapters are linked on the left and right margins of the bottom, and chapter components such as diseases / anatomy / etc. could be added to the center. It may not all fit, but even having a couple of navigation points within the chapter would be helpful.

Good organization and order of chapters.

This is one of my greatest difficulties. Navigation within chapters would be helpful. The incorporation of activities, particularly the labeling activities and Medical Terms in Context, are difficult with a regular laptop screen. The text and answer selections are often not on the same screen, making the activity more tedious to complete. Some of the labeling activities also have large images that put the image and answer selections on different screens. The "Did You Know", "Objectives" and colored boxes contain wasted space. They're excessively large especially in the header, and when viewing on a laptop is often half the screen if not more. The PDF version often has issues of inconsistent font size and misalignment of tables.

No grammatical errors found. I appreciated the bold and linked words, with the ability to see definitions with one click. It might be helpful to have a sidebar with the important words and definitions / information in the section, but that might not be feasible with formatting.

Hard to assess for medical terminology.

The best way to use this text is online with solid internet. The PDF version is frustrating as there are no activities or practice opportunities, and there are issues with the organization and appearance such as misaligned tables and font size differences. When internet is good but not great, none of the videos are viewable. The activities and practice opportunities in the online book are very helpful and enjoyable. Their length is appropriate to encourage use and they are strategically placed throughout the chapters. I did have trouble with the search tool, as things I entered went to the glossary but always included the beginning of the glossary. For example, a search for "diplopia" showed the following:

Abdominal Pertaining to the abdomen (National Cancer Institute, n.d.) Abdominoplasty Surgical repair of the abdomen (National Library of Medicine, 2021) Abduction Moving the limb or hand laterally away from the body, or spreading the fingers or toes (Betts et al., 2013) Abductor Moves the bone away from the midline (Betts et al., 2013) Ablation The Read more » Sensory Systems

Learning Objectives Examine the anatomy of the sensory systems Determine the main functions of the sensory systems Differentiate the medical terms of the sensory systems and common abbreviations Discover the medical specialties associated with the sensory systems Recognize common diseases, disorders, and procedures related to the sensory systems Sensory Systems Word Parts Click on prefixes, Read more »

Overall, the authors did a wonderful job of developing a thorough and practical text. I appreciate the thought that went into the interactive nature of the book and the availability to exercises to practice knowledge.

Reviewed by Debra Minzola, Associate Professor, Bloomsburg University of Pennsylvania on 3/18/22

This textbook is very inclusive in the content area. It not only discusses the word but breaks down medical terminology to help learners to easily decipher the meaning of a medical term . read more

This textbook is very inclusive in the content area. It not only discusses the word but breaks down medical terminology to help learners to easily decipher the meaning of a medical term .

There was no inaccuracies detected throughout the text.

This text is very relevant and will easily be updated if needed.

This is an easy to read text and would be a valuable resource for new learners. The ebook offers videos and learning activities throughout.

The text is internally consistent with an easy to follow framework.

The modules in this text are easy to navigate and locate specialty sections.

This text is clearly organized and easy to navigate.

There is no significant navigation problems or confusing features.

There is clear grammar throughout the text.

There is no offensive content in this textbook or language that can be viewed as culturally insensitive.

Learning objectives are listed at the introduction of each section followed by a guide on how to break down each system's medical terms. Throughout each section there are diagrams, charts, and additional videos in the ebook which reinforces the content. The book is organized and easy to navigate.

Table of Contents

• 1. Word Parts and Rules
• 2. Prefixes and Suffixes
• 3. Body Terminology
• 4. Sensory Systems
• 5. Integumentary System
• 6. Skeletal System
• 7. Muscular System
• 8. Nervous System
• 9. Cardiovascular System
• 10. Blood Vessels and Blood
• 11. Lymphatic and Immune Systems
• 12. Respiratory System
• 13. Digestive System
• 14. Endocrine System
• 15. Urinary System
• 16. Male Reproductive System
• 17. Female Reproductive System
• 18. Obstetrics

Ancillary Material

About the book.

Medical Terminology for Healthcare Professions is an Open Educational Resource (OER) that focuses on breaking down, pronouncing, and learning the meaning of medical terms within the context of anatomy and physiology. This resource is targeted for Healthcare Administration, Health Sciences, and Pre-Professional students.

About the Contributors

Andrea M. Nelson , PT, DPT, GCS, CLT, University of West Florida

Katherine Greene , MPH, University of West Florida

Contribute to this Page

Practice Quizzes for Chapter 5, Respiratory System

Each chapter has an online quiz for  word parts, terms built from word parts, terms not built from word parts, and abbreviations .

View of Opening Screen

View of a Terms Built from Word Parts Practice Quiz

Basic Medical Language , 7th Edition, by Danielle LaFleur Brooks and Myrna LaFleur Brooks , and Dale Levinsky. This textbook fully engages the student in learning and using medical terminology. Ideal for 1 or 2 credit college courses, highschools, private schools, and self-learning.

Click on the textbook lessons below to read blog posts for each lesson.

• Lesson 1: Introduction to Medical Language, Body Structure, Oncology, and Laboratory Tests
• Lesson 2: Directional Terms, Positions, and Imaging
• Lesson 3: Integumentary System, Colors, and Plural Endings
• Lesson 4: Respiratory System
• Lesson 5: Urinary System
• Lesson 6: Reproductive Systems
• Lesson 7: Cardiovascular and Lymphatic Systems
• Lesson 8: Digestive System
• Lesson 9: Eye and Ear
• Lesson 10: Musculoskeletal System
• Lesson 11: Nervous System
• Lesson 12: Endocrine System

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Exploring medical language.

NEW! Exploring Medical Language , 11th Edition, by Myrna LaFleur Brooks , Danielle LaFleur Brooks , and Dale Levinsky is a leading innovative worktext. Ideal for in-class and online 2 or 3 credit college courses, highschool, and self-learning. First published in 1985!

Master Medical Terms on Your Terms

Clickable links for chapter blog posts.

• Chapter 1: Introduction to Medical Language
• Chapter 2: Body Structure, Color, and Oncology
• Chapter 3: Directional Terms
• Chapter 4: Integumentary System
• Chapter 5: Respiratory System
• Chapter 6: Urinary System
• Chapter 7: Male Reproductive System
• Chapter 8: Female Reproductive System
• Chapter 9: Obstetrics and Neonatology
• Chapter 10: Cardiovascular and Lymphatic Systems
• Chapter 11: Digestive System
• Chapter 12: Eye
• Chapter 13: Ear
• Chapter 14: Musculoskeletal System
• Chapter 15: Nervous System
• Chapter 16: Endocrine System

Are you interested in submitting a topic, being a guest contributor, or starting a conversation?

I would like to hear from you. e-mail me at this link .

Your information will not be shared without your consent.

Recent Posts

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• Medical Terminology Quiz: Dermatology
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• Medical Terminology Crosswords
• Medical Terminology Faculty Tips
• Medical Terminology New Terms
• Medical Terminology Word Jumbles
• Medical Terminology Quizzes
• Medical Terminology Featured Terms

Interactive Textbook

This  Interactive Textbook section of the Medical Terminology book contains digital interactive activities interspersed with reading material in each chapter. The interactive activities are also repeated in a Test Yourself section at the end of each chapter, because reviewing material shortly after learning it is a form of spaced repetition that will help you remember what you learn.

If you prefer, you will find the same activities in a simple, straightforward format that is suitable for printing, study, and review in the Printable Student Companion section of this book.

Medical Terminology Copyright © 2024 by Phoenix College Nursing is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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InterActive Medical Terminology

The easy way to learn the language of medicine, medical terminology.

Learn Medical Terminology in a quick and engaging way by using the best selling book by Andy Hutton.  An Introduction to Medical Terminology for Health Care (Pub. Elsevier Ltd.)Try the free exercises on this site and our Apps on Google Play to support your learning.

Suitable for medical secretaries, transcriptionists, medical assistants, premedical students, nursing students, nurses, and allied health students, in fact anyone with an interest in the language of medicine or medical education. Invaluable revision for all health care courses including: City and Guilds (AMSPAR) Certificate in Medical Terminology at Levels 2 and 3, CMA / AAMA (American Association of Medical Assistants) Medical Terminology Exam, SQA Medical Terminology, NHS training courses and medical secretary training courses.

If you are about to go to medical school or nursing college be one step ahead and impress your new tutors. If you are a nurse, medical secretary or allied health student learning English, studying the self-teaching book and free exercises  will enhance your listening, writing and spelling skills. Now widely used for general practice (GP) staff training.

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Progression From Presymptomatic to Clinical Type 1 Diabetes After COVID-19 Infection

• 1 Institute of Diabetes Research, Helmholtz Munich, Munich, Germany
• 2 Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany

The incidence of type 1 diabetes increased during the COVID-19 pandemic. 1 Temporal relationships between COVID-19 infection and the incidence of type 1 diabetes as well as the development of islet autoimmunity are reported. 2 , 3 It remains unknown whether COVID-19 infection accelerates disease progression in children with preexisting islet autoimmunity. The study examined whether there is an association between COVID-19 infection and progression to clinical diabetes in youth with presymptomatic type 1 diabetes.

Read More About

Friedl N , Sporreiter M , Winkler C, et al. Progression From Presymptomatic to Clinical Type 1 Diabetes After COVID-19 Infection. JAMA. Published online July 15, 2024. doi:10.1001/jama.2024.11174

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Long-term, 30-year CVD risk may help inform therapy for stage 1 hypertension

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A comparison of two risk prediction tools used to calculate an individual's risk of developing cardiovascular disease (CVD) suggests that the long-term, 30-year risk should be considered in addition to the short-term, 10-year risk to help inform when to begin medication therapy for stage 1 hypertension, or high blood pressure, according to new research published today in Hypertension, an American Heart Association journal.

Many people may not have a heart attack or stroke, or develop heart failure in the next few years, yet they may benefit from lowering their blood pressure to protect them against having a heart attack, stroke or heart failure later in life. Experts who develop cardiovascular disease guidelines may want to consider both near-term risk and lifetime risk for having heart disease, stroke and heart failure in lifestyle changes and treatment recommendations." Paul Muntner, Ph.D., M.H.S., FAHA, lead study author and visiting professor in the department of epidemiology at the University of Alabama at Birmingham

The study compared the predicted risks estimated by the American Heart Association's PREVENT TM risk calculator, released in 2023, to the previous tool for risk prediction called the Pooled Cohort Equations (PCE). PREVENT, an acronym for Predicting Risk of (Cardiovascular) CVD Events, uses sex-specific equations; incorporates markers of kidney disease in addition to HbA1c measures to help monitor metabolic health; can estimate 10-year and 30-year risk for heart attack or stroke as well as heart failure; and considers additional risk factors with the social deprivation index. The Pooled Cohort Equations do not calculate 30-year risk and do not include heart failure or additional risk factor predictors such as kidney function or statin use.

The Pooled Cohort Equations were designed to assess 10-year risk of heart attack and stroke for individuals ages 40 to 79, however, PREVENT can assess CVD risk in individuals from ages 30 to 79, and can predict risk for heart attack, stroke and/or heart failure over the next 10 years and 30 years. According to the 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, a predicted risk of heart attack or stroke estimated by the PCEs of 10% or greater over the next 10 years, among other criteria, was considered high risk and should prompt health care professionals to discuss blood pressure-lowering medication with their patients. Blood pressure-lowering therapy for stage 1 hypertension includes diet and physical activity changes and medication, as appropriate.

For this study, the researchers considered a risk of heart attack, stroke and/or heart failure of 15% or higher over 10 years to be high-risk using the PREVENT calculator. In contrast, the Pooled Cohort Equations consider a risk of heart attack and/or stroke of 10% or higher over 10 years to be high-risk. Researchers analyzed data from the U.S. National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020 for 1,703 adults ages 30 to 79 years old who had stage 1 hypertension (130-139 mm Hg/80-89 mm Hg). The analysis compared participants' predicted risk estimates of CVD using both calculation methods. It found:

• Participants' average 10-year estimated risk for heart attack and stroke was 2.9% when calculated by the PREVENT calculator, in comparison to the Pooled Cohort Equations' estimate of 5.4%. This means that if treatment guidelines utilized the same threshold for PREVENT as for PCEs, some people may not be told to start blood pressure-lowering medication therapy based on the PREVENT prediction.
• Some of these people, however, did have a high risk for heart attack, stroke and heart failure over the next 30 years, which can now be estimated by the PREVENT calculator: 55.3% of adults who had a high 10-year risk with the Pooled Cohort Equations had a low 10-year risk using PREVENT; however, the 30-year risk was greater than or equal to 30%, which may be considered high risk. This indicates the potential need for clinicians to consider both short- and long-term cardiovascular risks with their patients who have high blood pressure (BP), the authors noted.

"Many people with stage 1 high blood pressure who are not likely to have a heart attack, stroke, or heart failure within the next 10 years may have a high risk over the next 30 years," Muntner said. "People may want to discuss this with their doctors and consider starting antihypertensive medication to lower their blood pressure to reduce their risk for heart attack, stroke and heart failure across their lifetime even if they have a low short-term risk."

Study design, background and details:

• The average age of study participants with stage 1 high blood pressure was 49.6 years; 55% self-identified as men, and 45% self-identified as women. Among this group, 65.8% self-identified as white adults, 15.5% as Hispanic adults, 10.1% as Black adults, 5.8% as Asian adults and 2.7% were listed as other race or ethnicity.
• In addition, 17.2% of participants smoked cigarettes, 9.6% were taking a statin medication to lower cholesterol, 8.4% had either Type 1 or Type 2 diabetes, and 9.1% had chronic kidney disease.
• Study participants all had stage 1 hypertension, as determined by up to three blood pressure measurements at one appointment during the NHANES data collection period from 2013 to 2020. Because the study was cross-sectional, blood pressure was measured during a single office visit.
• Participants had answered questions during the NHANES enrollment period about their age, sex, race, ethnicity, smoking status and having a prior diagnosis of coronary heart disease, heart attack, heart failure, stroke, Type 1 or Type 2 diabetes, or high blood pressure. Participants who had reported a prior diagnosis of coronary disease, heart attack, stroke or heart failure, were excluded from the analysis.

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"Cardiovascular prevention is important for people who identify in all race groups and all ethnic groups. Non-Hispanic Black adults have a higher risk of stroke and heart failure in the U.S. compared with people in other groups including non-Hispanic white adults," Muntner said. "However, we know that treatments are equally effective for people in these groups. Therefore, ensuring equal access to treatments that lower blood pressure is important for all adults."

The study had several limitations. Participants' blood pressure levels were measured during a single visit in NHANES during the study period versus the two or more readings at different office visits recommended by the American Heart Association's 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. The researchers pooled NHANES data from 2013 to 2020 to have an adequate sample study size to produce statistical estimates of predicted risk. During five of the years from which data was included, the 10-year risk of cardiovascular disease using the Pooled Cohort Equations was stable. Additionally, the data used was cross-sectional, meaning it examined the characteristics of the study population at one point in time and did not include data about CVD outcomes, and therefore, the study's results cannot conclusively state which model is better at predicting the risk of developing cardiovascular disease.

"We know from emerging and growing evidence from clinical trials that blood pressure-lowering is effective at reducing risk of CVD with greater benefit among those who are at higher baseline risk. This study highlights that the burden of stage 1 hypertension is high, and our goals as clinicians, health systems and as a society should be to focus on keeping BP as optimal as possible for as long as possible, whether this is through lifestyle and possibly initiation of blood pressure medication when lifestyle alone is not sufficient. The question of when to start BP-lowering medication comes from clinical trial data, such as the SPRINT trial and the recently published ESPRIT trial where intensive BP-lowering was beneficial among people with CVD or at increased risk of CVD. Focusing efforts on those who are at higher predicted risk with the most accurate and precise model available allows us to most effectively and efficiently improve population health outcomes," said Sadiya S. Khan, M.D., M.Sc., FAHA, chair of the writing group for the Association's 2023 scientific statement, "Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health." Khan is the Magerstadt Professor of Cardiovascular Epidemiology and an associate professor of medicine and preventive medicine at the Northwestern University Feinberg School of Medicine and a preventive cardiologist at Northwestern Medicine, both in Chicago, and was not involved in the study.

"The authors should be commended for examining both 10- and 30-year risk, as the latter is a valuable addition in the PREVENT models to enhance risk communication discussions with patients," Khan said. "As we know from the guidelines for blood pressure, cholesterol and primary prevention, estimating risk is the first step to initiate a patient-clinician discussion, and inclusion of other risk enhancing factors are also needed. For example, individuals who have high blood pressure during pregnancy (preeclampsia) are at approximately two-fold higher risk of CVD and should be considered for more intensive prevention measures, including earlier consideration for initiation of blood pressure-lowering medications. This work also helps to highlight the importance of clinical trials in younger populations who are at high 30-year risk and select populations like those with preeclampsia to better understand the thresholds to initiate medication and the targets for treating BP with medications."

American Heart Association

Muntner , P.,  et al . (2024) Predicted Cardiovascular Risk by the PREVENT Equations in US Adults With Stage 1 Hypertension.  Hypertension.   doi.org/10.1161/HYPERTENSIONAHA.124.22998 .

Posted in: Medical Research News | Medical Condition News

Tags: Blood , Blood Pressure , Cardiovascular Disease , Cholesterol , Chronic , Chronic Kidney Disease , Clinical Trial , Coronary Disease , Coronary Heart Disease , CT , Diabetes , Diet , Epidemiology , HbA1c , Health Care , Health Insurance , Health Systems , Heart , Heart Attack , Heart Disease , Heart Failure , High Blood Pressure , Kidney , Kidney Disease , Medicine , Nutrition , pH , Physical Activity , Pregnancy , Research , Smoking , Statin , Stroke , Type 2 Diabetes

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