Cardiologists at Johns Hopkins are reporting that the traditional method of assessing the heart disease risk factors in women are fraught with the danger of missing one-third of women who are predisposed to develop coronary heart disease (CHD).
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 has authored two reports delving into this topic. "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," he said. The Framingham Risk Estimate (FRE) is considered to be a standard test for the assessment of risk factors for the heart diseases. But these two studies from Johns Hopkins say that additional criteria must also be considered.
In the current study, researches measured the FRE values of women who were participating in the Sibling and Family Heart Study. Almost 98 percent of these women were classified as having a low risk fro a fatal heart event. But when the researchers measured the calcium build-up in the arteries, they found that one-third of women, who were thought to be in the low-risk category based on FRE scores, had coronary atherosclerosis. These measurements were based on CT scans. Since performing these scans is not feasible among all women, researchers say that people who smoke or have a relative with heart disease are more likely to have excess calcium. "Our results show that if a CT scan had not been performed in addition to traditional risk-factor scoring, a large number of women would have missed the chance to begin preventive therapies," says cardiologist Erin Michos, M.D., a clinical research fellow at Hopkins and its Heart Institute. "For some women, especially those with a family history of heart disease and multiple risk factors for it, additional screening using CT scan and calcium scoring may be warranted."
Johns Hopkins Medical Institutions