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New Way to Predict Women's Heart Risk

Study Shows Latest Method for Predicting Heart Disease Risk Is Accurate
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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:

  • Age
  • Gender
  • 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 death.

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 guidelines.

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 over 20%.

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.

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