Accurately Predicting Cardiovascular Disease Risk in Women

Cardiovascular disease in women can now be precisely predicted through a recently-developed clinical tool. A new risk model called the Reynolds Risk Score accurately anticipates the ten-year risk of cardiovascular diseases (CVD) in women. The development and validation of the new global cardiovascular risk algorithm for women may dramatically alter the way women's heart disease risk is assessed. It may also mean that many women may have underrated their risks for cardiovascular diseases.

The risk of suffering a heart attack or stroke is the same for both men and women. But with women, it happens about ten years later. Evaluation of cardiovascular risk is often based on the presence or absence of traditional risk factors such as age, hypertension, smoking, diabetes and hyperlipidemia. However, coronary events still occur even in the absence of these major risk factors.

Cardiovascular disease is the leading cause of death among American women. Currently, the methods used in the prediction of heart diseases in women have been based on traditional risk factors like blood pressure, age, smoking behavior and cholesterol. The traditional risk models, which were developed in the 1960s, did not accurately predict the risk of heart attacks in women and did not show any of the risk factors. The heart disease risk factors back then were mainly based on data about men's heart health.

The Adult Treatment Panel III (ATP III) risk scores used today identified the following risk factors and used them as basis: age, high blood pressure, smoking, diabetes and high levels of cholesterol. These risk scores help physicians distinguish treatments for their patients. But it has long been observed that the traditional risk factors are not totally applicable to women because many women still develop heart diseases even without the standard risk factors. The Reynolds Risk Score was compared with predicted versus actual 10-year cardiovascular disease event rates. The new algorithms were compared with models from ATP-III. The new risk prediction tool re-classified 40% to 50% of women at intermediate (ATP-III) risk into higher- or lower-risk categories. The new tool is being seen as a step forward for women who had been short-changed with some of the earlier risk factor tools that just used populations of men.

The Reynolds Risk Score, which uses traditional and novel risk factors, takes into account the levels of bad cholesterol (HDL), the higher reading of systolic blood pressure, the C-reactive protein level in a woman's blood, and if there is a history of a parent who suffered a heart attack before the age of 60. Women with increased levels of C-reactive proteins have been found to have higher risk for hypertension and cardiovascular disease. C-reactive protein levels increase in cases when the body is fighting inflammation, such as arterial damage.

Specifically, the Reynolds Risk Score uses 6 questions that relate to include age, smoking status, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol (HDL), C-reactive protein, and parental history of heart attack before age 60. When these questions are answered, a calculator measures the ten-year cardiovascular disease risk. It also shows what the risk would be if the woman changed those risk factors.

The new Reynolds Risk Score model also accurately reclassifies women who would have been put at intermediate risk using traditional methods into either higher or lower risk categories.