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Traditional risk-factor scoring misses one-third of women vulnerable to coronary heart disease

Traditional risk-factor scoring fails to identify approximately one-third of women likely to develop coronary heart disease (CHD), the leading cause of death of women in the United States, according to a pair of reports from cardiologists at Johns Hopkins.

"Our best means of preventing coronary heart disease is to identify those most likely to develop the condition, and intervene with lifestyle changes and drug treatment before symptoms start to appear," says the senior author of both studies, cardiologist Roger Blumenthal, M.D., an associate professor and director of the Ciccarone Preventive Cardiology Center at The Johns Hopkins University School of Medicine and its Heart Institute. "The goal is to strongly consider therapies, such as aspirin, cholesterol-lowering medications and, possibly, blood pressure medications for individuals at higher risk, so that heart attacks will be less likely to occur in the future."

The Hopkins findings, the latest of which appear in the American Heart Journal online Dec. 16, is believed to be one of the first critical assessments of the Framingham Risk Estimate (FRE) as the principal test for early detection of heart disease. The researchers wanted to determine why many of these women at risk for heart disease are not identified earlier.

The FRE is a total estimate of how likely a person is to suffer a fatal or nonfatal heart attack within 10 years, and it is based on a summary estimate of major risk factors for coronary heart disease, such as age, blood pressure, blood cholesterol levels and smoking.

However, Blumenthal says, many women with cardiovascular problems go undetected despite use of the Framingham score. While the death rate for men from cardiovascular disease has steadily declined over the last 20 years, the rate has remained relatively the same for women, he says.

In their latest report, the Hopkins researchers examined the risk of premature CHD in women whose average age
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Contact: Gary Stephenson
gstephenson@jhmi.edu
410-955-5384
Johns Hopkins Medical Institutions
16-Dec-2005


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