Cardiologists want to enhance testing for women's heart problems

• "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 Hopkins findings, the latest of which appear in the American Heart Journal online today, 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.
• 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.
• The researchers calculated each woman's Framingham score and found that 98 percent were gauged to be at very low risk for future CHD, with an FRE of less than 6 percent, while only 2 percent of participants were judged to be at intermediate risk for future CHD, with an FRE between 10 percent and 20 percent.
• When the results were contrasted with evidence gleaned from CT-scan measurements of calcium build-up in the arteries, the researchers found that one-third of women originally classified as very low risk actually had coronary atherosclerosis, a hardening and narrowing of the arteries that can lead to heart attacks if not controlled with drug therapy along with diet, exercise and other lifestyle changes.
• "We wanted to verify if the Framingham score truly captured who was most at risk, but it turns out to have underestimated a large number of those who should be considered for preventive therapies," says Blumenthal.