Scoring Method Misses Women's Heart Disease Risk

Doctors may not be spotting a third of women at risk for heart attack, study finds

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FRIDAY, Dec. 16, 2005 (HealthDay News) -- A new study finds that about a third of women who are likely to develop coronary heart disease are not identified by a risk-factor scoring method doctors routinely use to assess heart attack risk.

The Framingham Risk Estimate (FRE) is used to estimate a person's risk of suffering a fatal or nonfatal heart attack within 10 years. The test is based on a number of major risk factors for coronary heart disease, including age, blood pressure, smoking, and blood cholesterol levels.

In one study, researchers from Johns Hopkins University compared the FRE results of women, average age 50, who had no symptoms of heart disease but had a sibling who'd been hospitalized with a heart attack or other kind of coronary event.

Using the FRE, the researchers found that 98 percent of the women were considered to be at low risk for future coronary heart disease while 2 percent were judged to be at intermediate risk. The researchers then compared these FRE scores to CT scans of calcium buildup in the women's arteries. Calcium buildup is a sign of atherosclerosis (hardening of the arteries).

The CT scans indicated that a third of the women classified as low risk according their FRE scores actually had coronary atherosclerosis.

"We wanted to verify if the Framingham score truly captured who was most at risk, but it turns out to have underestimated a large number of those who should be considered for preventive therapies," senior author and cardiologist Dr. Roger Blumenthal, associate professor and director of the Ciccarone Preventive Cardiology Center at Hopkins, said in a prepared statement.

He and his colleagues concluded that people with two or more risk factors for heart disease should be given a cardiac CT scan, even if these people have low FRE scores.

An earlier study by the same Hopkins team found that 84 percent of 489 women classified as low risk by FRE actually had some coronary atherosclerosis, which was detected by CT scan.

The study appears in the Dec. 16 online edition of the American Heart Journal.

More information

The American Heart Association has more about women and cardiovascular disease.

SOURCE: Johns Hopkins Medicine, news release, Dec. 16

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