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Heart
Beats
News for helping hearts stay
healthy |
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Better assessment needed of older women's
heart disease risk
Call made for changes in women's heart disease risk-factor list - Family history and blood C-reactive protein should be added to
traditional risk factors for all older women
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 Johns Hopkins cardiologists are calling for an expansion of the criteria
widely used by physicians to detect and assess a postmenopausal woman's
chances of developing cardiovascular disease, the leading cause of death
among women in the United States.
In an editorial appearing in the Journal of the American Medical
Association (JAMA) online , Roger Blumenthal, M.D., and
colleagues say that a family history of heart disease and blood levels
of a protein tied to vessel inflammation, C-reactive protein, should
quickly be added to traditional assessments of women's risk of suffering
a heart attack, stroke or severe chest pain (angina).
"Physicians should incorporate these factors into their testing and
decision-making about which women are most likely to develop
cardiovascular disease," says Blumenthal, "And physicians should
intervene with lifestyle changes and drug treatment before symptoms
start to appear," he adds. "Our best means of prevention is through
early identification of those most at risk."
 This change in practice could help reduce the discrepancy between the
death rates of heart disease in men and women. While men’s rates have
declined over the last 20 years, women’s have remained the same.
The new risk-factor list would strengthen existing assessment tools
which gauge how likely a person is to suffer a fatal or nonfatal heart
attack within 10 years based on such factors as age, blood pressure,
cholesterol levels and smoking.
The Hopkins experts base their editorial call on research which looked
at the predictive value of more than 35 risk actors not usually studied
but reported to play a role in heart disease and stroke.
They found clear evidence that only family history and C-reactive
protein had significant, additional value in determining women really at
moderate or high risk of future cardiovascular disease. The new method
changed risk scores for at least 20 percent of the women studied.
 "These are the best data yet to show how we should be assessing our
female patients," says Blumenthal, whose own research showed in 2005
that standard testing failed to identify approximately one-third of
women over age 60 who had advanced hardening and narrowing of the
arteries for their age and sex.
Family history - where either a parent or a sibling suffered a coronary
event - doubles a woman's own chances of arterial disease. High blood
levels of C-reactive protein, in excess of 3 milligrams per liter, also
double the risk. And the effects are multiplied if both factors are
present, with a woman's risk rising almost fourfold.
This article first appeared
in 2007. |
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