New Way to Predict Women's Heart Risk
Study Shows Latest Method for Predicting Heart Disease Risk Is Accurate
WebMD News Archive
The Framingham Heart Risk Method
Hsia's team compared the new AHA approach to one commonly used approach from
the Framingham Heart Study, a long-running study of heart disease launched in
1948, that uses seven characteristics to compute the predicted risk of heart
problems over the next 10 years:
- Total cholesterol
- HDL "good" cholesterol
- Systolic blood pressure (upper number)
- Need for blood pressure medication
- Cigarette smoking
For instance, a woman who is 50 with healthy cholesterol levels (175 total
and 60 HDL), doesn't smoke, is on blood pressure medication, and keeps systolic
pressure at 120 would have a 10-year risk of 1% for heart attack or coronary
Those categorized as high-risk using this method have a 10-year risk of more
than 20% and a history of heart disease or diabetes.
Testing the AHA Guidelines
Hsia and her colleagues found that 11% of the WHI participants were high
risk, 72% were at risk, and 4% at optimal or low risk using the AHA
Another 13% could not be categorized as they lacked risk factors but didn't
have good lifestyle habits. That group may need to be addressed in future
version of the guidelines, says Hsia.
At the follow-up about eight years later, women in the high-risk group were
more likely to have a heart attack or die of coronary disease than were the
lower-risk women. While 12.5% of the high-risk women had a heart attack or died
from heart disease, 3.1% of the at-risk women did, and just 1.1% of the
optimal-risk women did over 10 years.
When Hsia's team compared the new guidelines with the Framingham risk
prediction, they found the new guidelines predicted heart problems with
accuracy similar to the Framingham categories of less than 10%, 10% to 20%, and
The AHA guidelines were less accurate, however, than another Framingham
approach, which uses risks of less than 5%, 5% to 20%, and over 20%.
The new guideline, however, ''is more accessible," Hsia says. "It's easier
for practitioners to use, easier for patients to understand. I am not saying
this [AHA] guideline is preferable to Framingham, but it's worth considering,"
Hsia tells WebMD.
Based on the risk category, a doctor can then work with the woman to control
or eliminate the risk factors.