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New Reynolds Risk Score Predicts Women’s Risk of Heart Disease, Stroke
BWH researchers have developed a Web-based formula that more accurately predicts the risk of heart attack and stroke among women. In addition to the usual risk factors of cholesterol, blood pressure and smoking, the Reynolds Risk Score takes into account two new factors: blood level of C-reactive protein (a measure of artery inflammation) and family history of heart attack prior to age 60.
“Women as well as men suffer premature heart attacks and stroke, but our standard methods for risk prediction have not been as effective in preventing disease among women,” said cardiologist Paul Ridker, MD, MPH, director of the Center for Cardiovascular Disease Prevention and lead author of the study, published in the Feb. 14, 2007 issue of the Journal of the American Medical Association. “We often underestimate women’s risk of heart disease and stroke.”
The Reynolds Risk Score provides doctors and patients with a much clearer picture of who should or should not receive drug therapies such as statins and aspirin, and it highlights the critical impact that diet, exercise and smoking cessation can have on heart disease prevention.
“There’s an enormous opportunity for prevention because if physicians can accurately tell a woman in her 30s or 40s about true lifetime risk, they have a much better chance of motivating her to stop smoking, get regular exercise, reduce her blood pressure and, where indicated, begin a statin or aspirin regimen,” Ridker said.
In fact, researchers found that nearly 50 percent of women in the study who were deemed to be at intermediate risk for heart attack or stroke based on current guidelines were actually at considerably higher or lower risk levels according to the Reynolds Risk Score.
“When information on C-reactive protein and family history were incorporated into our prediction models, they improved the fit and predicted risk more accurately,” said Nancy Cook, ScD, the study statistician. “For some women, changes were striking enough to potentially affect treatment decisions or alter behavior.”
The Reynolds Risk Score was derived from a study of 24,458 initially healthy women enrolled in the Women’s Health Study in 1992. They were followed for more than a decade for the occurrence of heart attack, stroke and other major cardiovascular events. The researchers evaluated 35 different risk factors to come up with the best possible prediction tool for clinical use and then directly compared the new prediction tool to traditional approaches.
Women and their physicians can access the Reynolds Risk Score at www.ReynoldsRiskScore.org. In addition to providing a woman with an estimate of her risk of suffering a future heart attack, stroke or other cardiovascular event in the next 10 years, the Web site also shows a woman what her risk would be if she improved each of her individual risk factors.