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One in five women had a higher risk than the Framingham Risk Score predicted.

Pay attention to a woman's heart

The probability of woman of suffering from cardiovascular diseases is often underestimated. A recent study evaluated the risk of nearly 9.000 women in the U.S. screened for heart-health risk: one in five women had a higher risk than measured by a frequently used predictor.

Exactly 8,936 women screened for heart-health at the Sister to Sister National Woman’s heart Day events in 14 major U.S. cities have been evaluated for their personal risk of developing a cardiovascular disease. The screening included the identification of the cholesterol levels, blood glucose levels, blood pressure, body mass index and/or measurement of waist circumference, as well as standardized questions to gather demographic data, individual and family medical history, and use of medication.
 
Most of the women studied showed a high prevalence of one or several risk factors for heart disease. Forty percent had low levels of the good cholesterol (HDL) and 27% had elevated levels of the bad cholesterol (non-HDL). More than half had elevated blood pressure or pre-hypertension. Three quarters were deemed overweight or obese. Nearly half of the women were unaware of the association between risk factors such as high blood pressure and their own risk of developing cardiovascular disease. Many women were unaware of their risk factors at the time of their screening.

A Framingham Risk Score, a frequently used predictor for future heart problems, was calculated for each participant. By that measure, 85% of the participants without a previous history of cardiovascular disease were considered at low risk for a "hard" coronary heart disease event within the next ten years.

But the study authors found that nearly one in five of women with a low risk Framingham score had three or more risk factors for heart problems, with obesity being the most prevalent. This puts these women at increased lifetime risk for cardiovascular disease.

A Framingham low-risk score "can potentially lead to false reassurance and may lower motivation to engage in lifestyle modifications," the article said.

Obesity is a significant risk factor for cardiovascular disease. It also can lead to the development of diabetes, hypertension, osteoarthritis, gall bladder disease, liver disease and many cancers. Studies have demonstrated that active women have lower risk for heart disease than inactive women and that even light to moderate regular activity, combined with a healthy diet, can reduce those risks.

The Journal study pointed out that women account for more than half of the nearly one million cardiovascular deaths per year in the United States. But many women do not realize they are at risk for heart disease, and their physicians may not treat their risk factors as aggressively as they should, the study reported. Since more than 25% of sudden cardiac death occurs among individuals with no prior symptoms of cardio-vascular disease, early identification of heart-health risk factors and preventive action such as life-style changes are of outmost importance.
 
Follow-up with a limited number of study participants indicated that many of them took action to reduce their cardiovascular risks identified at the Sister to Sister screening. More than 70% went to a doctor's office for follow-up care, nearly two-thirds changed their diet, nearly half lost weight and more than three in five increased their physical activity.

This article was published on 08/19/2008

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