Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.See all posts »
Predicting Your Cardiovascular Risk
Peering into the future of your heart health.
Cardiovascular disease kills more women and men than all forms of cancer combined. Although it will ultimately take the life of more than one in every three people, not everyone is at the same risk. Wouldn’t it be nice to know where you stand?
There are all sorts of ways to determine your individual risk. I’ll tell you about a low tech formula that has withstood the test of time, a blood test that can pinpoint higher risk individuals who might not carry conventional risk factors, and a high tech CT scan that can visualize cholesterol buildup in the arteries of the heart.
The Framingham Heart Study was a groundbreaking research phenomenon when it started up in 1948. At the time, very little was known about heart disease risk factors. Thanks in large part to the dedication of thousands of residents of the town of Framingham, Massachusetts, many of whom continue to be studied to this day, we understand a great deal more about the factors that contribute to heart disease and stroke.
From the data collected, we now have a straightforward way of calculating an individual’s 10-year risk for cardiovascular disease. All you need to know is your blood pressure and cholesterol profile. Add in your age, gender, and whether you smoke, and the calculator will compute your risk. You can enter your numbers quickly and anonymously into the formula at the National Heart Lung and Blood Institute’s website. A weakness of the Framingham score is that the formula does not take into account body weight or family history, which are both important risk factors.
A blood test for C-reactive protein (known as high-sensitivity CRP, or hs-CRP) can detect levels of inflammation that may be associated with a higher risk for heart disease. Studies that have included thousands of patients have found that high levels are at least as predictive of heart attack risk as high cholesterol. In fact, the risk may be three to four-fold higher than normal when hs-CRP levels are high.
Initially it was believed that hs-CRP itself was the culprit, but it now appears that it is a marker for an unhealthy lifestyle. Obesity, a diet high in saturated and trans fats, diabetes, and smoking are all associated with higher levels. Although a statin may be prescribed for high hs-CRP, improving these risk factors will lower levels substantially.
A coronary calcium score is obtained through a quick CT scan that evaluates the heart arteries. My February 8, 2011 posting reviewed this test in detail. When people with high hs-CRPs were evaluated with coronary calcium scores then followed for nearly six years, those with high calcium scores (greater than 100) were more than four times as likely to develop coronary heart disease as those with low scores.
A calcium score isn’t for everyone, but if you have one or two risk factors, or have a family history of heart disease at an early age (men before age 50 or women before 60), it’s worth asking your doctor whether this might be a useful test for you.
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