Women can now predict their risk of heart disease.

That researchers from Brigham and Women's Hospital in Boston developed a new cardiovascular disease evaluation tool especially for women is indeed, heart-warming. This tool, the Reynolds Risk Score, offers women a chance to know how prone they are to cardiovascular diseases for a decade, even two to three more1, 2. In addition to customary risk indicators, the tool comprises family history and blood levels of very sensitive C-reactive protein, a marker of inflammation.

 

Heart diseases among women should concern us all. Roughly, ten million American women for example, have heart disease, the foremost cause of death among them, and from which over a third of them die 43% with stroke included3. More women than men also die of heart disease every year3. Furthermore, recent studies showed that women are likelier than men are to have, and to transmit mutant genes that cause long-QT syndrome, a flaw in the heart’s electrical system associated with sudden death, one cause of the sudden deaths of some young athletes4. The aberrant gene also likelier passes on to daughters.

 

That persons with excessively long, QT intervals, seemingly healthy but in fact, prone to potentially fatal abnormal heart rhythms, yet, for example, a recent study indicates that women with chest pains, might be dying of heart disease needlessly due to doctors under-estimating the severity of their illnesses, hence unlikelier offered confirmatory diagnostic tests5 is instructive. Additionally, this study conducted in London showed that women diagnosed with angina were unlikelier given follow-up tests to confirm their condition, for examples, angiograms or treadmill exercise electrocardiograms ECGs), tests patients need to do to qualify for surgery, bypass surgery, for instance.

 

Does this study, which also showed that after 45 years, women have just as much angina as men do, but ominously that, its outcome tends to be worse than in men when they do, not suggest that women with angina should receive timely and correct treatment to lessen their risk of a heart attack? In the U.S., although many more women than men die of heart disease yearly, yet only about a third of women receive angioplasties, stents, bypass surgeries, and open-heart surgeries, and even less, implantable defibrillators3. Do doctors also play down women’s clinical presentation, in the U.S., and do they indeed, in other countries, worldwide?

 

Considering that, women develop angina at a comparatively high rate as men, would this new risk evaluation tool not make a difference to women’s cardiovascular health, and even help promote preventive initiatives among individual females, for example aspiring treatment to those that need it, not exposing it to those that do not? Indeed, this tool stresses the need to look beyond cholesterol levels, normal in fact, in about 50% of women with a heart attack, a fifth not having any known key risk factor, included in it, family history of cardiovascular problems, age, systolic blood pressure, smoking status, total and HDL or ‘bad’ cholesterol levels, and high sensitivity C-reactive protein (CRP) levels.

 

The tool empowers women to manage their risk factors, initiating appropriate diet and exercise programs for examples, which could reduce CRP levels, or quitting smoking, the most significant risk factor for heart disease, although having parents that had heart disease before 60 years and CRP are also important risk factors. No doubt, this tool has a potential major role to play in women’s health in future. Its prospects of reducing the prevalence of heart diseases, the principal cause of death in developed countries, and indeed, a leading cause of disability in persons middle-aged and over, some would say after arthritis6, promises for many an active and fulfilling aging process.

 

 

References

 

1. Ridker PM, Buring JE, Rifai N, Cook NR. Development and Validation of Improved Algorithms for the Assessment of Global Cardiovascular Risk in Women. The Reynolds Risk Score JAMA. 2007; 297:611-619.

2. Access the new risk assessment tool online at www.ReyoldsRiskScore.org.

3. Available at: http://www.womenheart.org/information/women_and_heart_disease_fact_sheet.asp Accessed on February 19, 2007

4. Imboden, M. The New England Journal of Medicine, Dec. 28, 2006; vol 355: pp 2744-2751

5. Hemingway H, McCallum A, Shipley M, Manderbacka K, Martikainen P, Keskimäki I. Incidence and Prognostic Implications of Stable Angina Pectoris Among Women and Men. JAMA. 2006; 295:1404-1411.

6. Available at: http://www.hearthealthywomen.org/index.php?option=com_content&task=view&id=343&Itemid=487 Accessed on February 19, 2007