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Leap made in calculating cardiovascular risk for women


Two new clinical algorithms can predict which women are at high risk for cardiovascular disease with far greater accuracy than traditional methods. And the shorter version of the two, the Reynolds Risk Score, does so with only two more pieces of information than that required by the third National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) risk assessment.

The findings come from following for a median of 10 years almost 25,000 initially healthy US women 45 years of age or older for cardiovascular events, including myocardial infarction (MI), ischemic stroke, coronary revascularization, and cardiovascular death.

Researchers found that both the longer version of the algorithm and the clinically simplified model were able to reclassify 40% to 50% of women formerly determined to be at intermediate risk into either higher or lower risk categories. The simplified version uses age, systolic blood pressure, hemoglobin A1c in the presence of diabetes, smoking, total and high-density lipoprotein cholesterol, high-sensitivity C-reactive protein (hsCRP), and parental history of MI before age 60 to make its determination, and predicts total cardiovascular disease events (including stroke and coronary revascularization) in addition to hard coronary heart disease (CHD) end points.

They also point out that since parental family history of premature CHD and hsCRP have been shown to predict CHD events in men, too, the findings may eventually impact the entire adult population.

Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007;297:611-619.

Blumenthal RS, Michos ED, Nasir K. Further improvements in CHD risk prediction for women. JAMA. 2007;297:641-643.