New Tool in the Fight Against Heart Disease in Women

Doctors have a new tool in the fight against heart disease in women: the Reynolds Risk Score. The Reynolds Risk Score is a seven-item calculator that incorporates new risk factors that can give a woman and her doctor the most accurate view ever of her heart risk. If a problem is detected, the Reynolds Risk Factor can also tell how much taking certain preventative actions, such as quitting smoking, may reduce the risk for a woman in danger of a heart attack.

Doctors certainly agree on the need to detect heart disease in women. While there is a perception that there is less risk for heart disease for a woman, the facts show the opposite. Heart disease kills more women every year than men. Heart disease accounts for more deaths in women than the next seven most common causes of death combined.

Other facts also show why the Reynolds Risk Score may be a valuable tool in fighting heart disease in women. Doctors are less likely to identify high risk women than high risk men, even though both may have similar profiles. Only one-third of women at high risk for heart attack because of high cholesterol levels are receiving medication for their condition. Women are less likely than men to get balloon angioplasty or stents to open blocked arteries. Women are referred for imaging tests less often than men, even though the women may show a risk for heart disease, and even though the tests are often beneficial to women. The American Heart Association has campaigned for years for women to realize their risks of a heart attack.

If you would like to calculate your own ten year risk of developing heart disease as a woman, you can learn your own Reynolds Risk Score at www.reynoldsriskscore.org.

You will be asked questions such as your age, whether you smoke or not, your systolic blood pressure, your total cholesterol, your HDL or good cholesterol, and whether or mother or father had a heart attack before age 60. There is also help on the site for filling in the information.

The new tool has already been valuable in fighting heart disease in women. Women identified as having an intermediate risk of having a heart attack, between five and ten percent in the next ten years, were reclassified as having a higher or lower risk of getting a heart attack. Doctors said doing that gave them a chance to give the women at the highest risk medication, possibly saving their lives. They also noted that previous tests to decide who has the highest risk for getting a heart attack were all developed for men and did not work as well when used on women.

The tool that had been used the most in the past for determining the risk of a heart attack was developed by the Framingham Heart Study. The federal research project has been used to study residents of a Massachusetts town for more than 50 years. It has been used mostly to identify factors that lead to a heart attack, such as high blood pressure, a history of smoking, and high cholesterol. The problem is men often don't know of a problem until they actually have a heart attack, while women may first get a stroke or chest pain caused by blocked arteries. Tests that only show the risk of a heart attack may not forecast the risk from other factors.

Experts point out that that deaths from heart attacks have been dropping in men for 25 years, but have not dropped in women.

The new tool in the fight against heart disease in women was recently described in the Journal of the American Medical Association. It adds family history to the evaluation. It also adds levels of C-reactive protein. Cardiologists agree that family history can be important in determining the risk of a heart attack in people in general, but perhaps even more so for women. Doctors are less certain about how much the can learn from the levels of C-reactive protein, but that factor is becoming more accepted.

The Reynolds score has not been used just to evaluate the risk of heart disease in women, but also the risk of a stroke and other cardiovascular problems that more often affect women them men. The test also allows women to evaluate their risk for 40 years into the future.

A 45-year-old smoker with slightly elevated cholesterol and blood pressure, slightly low "good" cholesterol, and a C-reactive protein reading that was slightly high was found under the new test to have only a four percent chance of a heart attack in the next ten years. If the levels stay the same, however, the risk jumps to 20 percent at age 65 and 38% at age 75.

While nothing is certain in fighting heart disease, the Reynolds Risk Factor is one new tool that is already showing promise for women.