Guideline-Based Cardiovascular Risk Assessment Delivered by an mHealth App: Development Study

Figure 1. Correlation of age and 10-year risk of cardiovascular disease for different personas. This figure demonstrates the correlation between age and 10-year risk of cardiovascular disease for unhealthy, average, and healthy personas for Framingham Risk Score (FRS), Systematic Coronary Risk Evaluation 2 (SCORE2), and SCORE2–Older Persons (SCORE2-OP) in their respective age ranges used in the HerzFit risk calculator. Healthy persona: male, nonsmoker, nondiabetic, systolic blood pressure (SBP) 125 mm Hg, no blood pressure (BP) treatment, total cholesterol (TC) 170 mg/dL, and high-density lipoprotein cholesterol (HDL-C) 70 mg/dL. Average persona: male, nonsmoker, nondiabetic, SBP 130 mm Hg, no BP treatment, TC 200 mg/dL, and HDL-C 50 mg/dL. Unhealthy persona: male, smoker, nondiabetic, SBP 155 mm Hg, no BP treatment, TC 250 mg/dL, and HDL-C 40 mg/dL.

Figure 2. Correlation of age and heart age in the HerzFit risk calculator. This figure demonstrates the correlation of real age and heart age for unhealthy, average, and healthy individual personas for Framingham Risk Score (FRS), Systematic Coronary Risk Evaluation 2 (SCORE2), and SCORE2–Older Persons (SCORE2-OP) in their respective age ranges used in the HerzFit risk calculator. Healthy persona: male, nonsmoker, nondiabetic, systolic blood pressure (SBP) 125 mm Hg, no blood pressure (BP) treatment, total cholesterol (TC) 170 mg/dL, and high-density lipoprotein cholesterol (HDL-C) 70 mg/dL. Average persona: male, nonsmoker, nondiabetic, SBP 130 mm Hg, no BP treatment, TC 200 mg/dL, and HDL-C 50 mg/dL. Unhealthy persona: male, smoker, nondiabetic, SBP 155 mm Hg, no BP treatment, TC 250 mg/dL, and HDL-C 40 mg/dL.

Figure 3. Presentation of heart age and risk in primary and secondary prevention. For individuals without cardiovascular disease, the HerzFit calculator estimates an individual’s heart age. The 10-year risk of recurrent events was estimated for people with established cardiovascular disease. In addition, the individual risk is compared with the mean and optimal risk. The screenshots were translated from German.

Figure 4. The effect of different risk profiles on heart age. This figure shows the effects of cardiovascular risk factors on heart age. Although a healthy man aged 45 years has a heart age of 37 years, and an average man of the same age has a heart age of 45 years, an unhealthy man of the same age can already have a heart age of 69 years. Healthy persona: nonsmoker, nondiabetic, systolic blood pressure (SBP) 125 mm Hg, no blood pressure (BP) treatment, total cholesterol (TC) 170 mg/dL, and high-density lipoprotein cholesterol (HDL-C) 70 mg/dL. Average persona: nonsmoker, nondiabetic, SBP 130 mm Hg, no BP treatment, TC 200 mg/dL, and HDL-C 50 mg/dL. Unhealthy persona: smoker, nondiabetic, SBP 155 mm Hg, no BP treatment, TC 250 mg/dL, and HDL-C 40 mg/dL.

Figure 5. HerzFit downloads from April 2022 to June 2023. Since its release in April 2022, the HerzFit app and risk calculator have been downloaded more than 96,000 times. The orange curve represents the total number of downloads. The green and blue curves mark the downloads per day on iOS and Android devices, respectively. In addition to a continuous increase in the total download numbers, repeated peaks in daily downloads were evident. This finding could be correlated with previous marketing campaigns and events.