Prediction Of Heart Disease Risk In Women Improved
The study is published in today's online edition of the Journal of the American Medical Association.
Scientists at Brigham and Women's Hospital in Boston have devised and tested a new risk model called the Reynolds Risk Score that accurately predicts the ten year risk of global cardiovascular in female patients.
"Women need to understand that their risk of suffering a heart attack, stroke or other cardiovascular disease is the same as it is for men, but it happens about 10 years later," said the study's lead scientist Dr Paul Ridker, Director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital.
Heart disease is the leading cause of death among American women, and current methods of predicting cardiovascular disease in women have used traditional risk factors such as blood pressure, age, smoking behaviour and cholesterol.
Using the traditional risk models, which were developed in the 1960s, many women would not show up as high risk. According to Dr Ridker, about 20 per cent of heart attacks in women would not be predicted using traditional methods, they just wouldn't show any of the risk factors. And half of women who have heart attacks have normal levels of overall cholesterol.
The Reynolds Risk Score also takes into account levels of bad cholesterol (HDL), systolic blood pressure (the higher reading), whether there is a history of a parent having suffered a heart attack before the age of 60, and the level of C-reactive protein in a woman's blood.
C-reactive protein levels go up when the body is fighting inflammation, such as damage to arteries, and research shows that women with increased levels of this protein are at higher risk for hypertension and cardiovascular disease. It also suggests higher risk of diabetes.
Altogether the researchers assessed 35 different factors from the records of 24,558 healthy American women aged 45 years or older. The women were followed up for about 10 years to pick up any incident cardiovascular events such as heart attack, stroke, bypass surgery, and death from heart disease.
They then selected two thirds of the records at random (16,400 women) and used the Reynolds Risk Score to estimate predictions. They tested their predictions on the remaining one third of records (8,158 women).
The main conclusion of the study was that using the new Reynolds Risk Score model, they were able to reclassify nearly 50 per cent of the women who would have been put at intermediate risk using traditional methods into either higher or lower risk categories.
Approximately 10 million American women fall into the intermediate risk category using traditional risk assessment tools. The Reynolds Risk Score would more accurately reclassify them into higher or lower risk.
According to Dr Ridker, the strongest risk factor for heart disease is smoking. But he suggested that women tell their doctors if either of their parents had a heart attack before they reached the age of 60 because that could also be important.
"Development and Validation of Improved Algorithms for the Assessment of Global Cardiovascular Risk in Women: The Reynolds Risk Score."
Paul M Ridker, Julie E. Buring, Nader Rifai, Nancy R. Cook.
Vol. 297 No. 6, Online February 14, 2007
Click here for Abstract.
Click here to access the Reynolds Risk Score online.
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