New Model to Better Predict Heart Risk
Family History, CRP Testing Could Improve Assessment in Women
Feb. 13, 2007 -- A new model for predicting heart disease and stroke risk
among women can help better identify those who need preventive treatment, say
the researchers who developed the model.
The model adds assessment of family history, as well as blood testing to
measure inflammation -- called C-reactive protein (CRP) levels, to the
established risk factors now used to predict the risk of heart attack or
Use of the model in a group of women previously classified as having an
intermediate risk for such a cardiovascular event resulted in reclassifying
between 40% and 50% of the women to either lower or higher risk categories.
The findings are published in the Feb. 14 issue of JAMA, TheJournal of the American Medical Association.
“We were very surprised that just these two items -- adding CRP and family
history – made such a large difference,” a study author, Paul M. Ridker, MD,
MPH, tells WebMD.
Leading Killer of Women
Coronary heart disease is the leading killer of women in the United States.
Nearly twice as many women die from heart disease and stroke as from all
Current models used to predict cardiovascular risk include assessment of a
patient’s age, total cholesterol level, high-density lipoprotein (HDL)
cholesterol level, smoking status, and blood pressure.
In an attempt to refine the model to more accurately predict risk in women,
Ridker and colleagues from Boston’s Brigham and Women’s Hospital examined 35
separate risk factors for stroke and heart disease in roughly 16,000 healthy
women followed an average of 10 years.
The researchers then tested the usefulness of their model in an additional
The researchers determined that just two of the new risk factors -- having a
mother or father who had a heart attack before age 60 and having a high
sensitivity C-reactive protein -- added to the ability to predict problems.
Ridker tells WebMD that the model, known as the Reynolds Risk Score, can
help doctors determine if a woman needs preventive treatments like low-dose
aspirin and cholesterol-lowering drugs (statins).
A major advantage of the new tool is that it predicts risk over many
decades, instead of just over 10 years. And it shows how lifestyle
changes such as stopping smoking will impact risk, Ridker tells WebMD.
The model can be found at www.reynoldsriskscore.org.
CRP Value Questioned
Cardiologist Roger S. Blumenthal, MD, tells WebMD his own work at Johns
Hopkins University in Baltimore, Md., showed the importance of including family
history in assessment of cardiovascular risk.
“Right away, practitioners around the country should start incorporating
family history into their assessment of [cardiovascular] risk,” he says.
The advice regarding C-reactive protein is not quite as clear. CRP blood
testing is not currently recommended as a routine test for measuring