How accurate is the famous Framingham Risk Score (FRS)? … not very. The best screeningA way to identify people who may have a certain condition, among a group of people who may or may not seem to tool is a CTThe abbreviation for computed tomography, a scan that generates a series of cross-sectional x-ray images scan that additionally measures calciumAn element that forms the structure of bones and teeth and is essential to many of the body's functions. deposits in the coronaryRelating to the arteries supplying the heart itself. arteries. This has been the view stated by totalhealth's senior cardiology consultants for some time, but it is now further corroborated by a recent paper published in the the Journal of the American Medical Association, JAMA.
The problem with the FRS is that it places a lot of people in the 'intermediate' risk category, including a good proportion who should probably be classed as 'high' risk. Lead author, Dr Yeboah said, "We know how to treat patients at low and high risk for heart disease, but for people who are at intermediate risk, we still are not certain about the best way to proceed."
So what are the usual factors for measuring heart risk? And what is the best screening method?
The "Top Six" Heart Risk Factors
Coronary arteryA blood vessel that carries blood away from the heart. Apart from the pulmonary artery and umbilical artery, all arteries carry oxygenated blood. calcium (CAC),
Carotid intima-media thickness (a measure of the thickness of the lining of the carotid arteryOne of the two main arteries found on either side of the neck.),
Ankle-brachial index (ratio of blood pressureThe pressure of blood within the arteries. in lower legs to bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. pressure in arms),
Brachial flow-mediated dilation (measure of health of the lining of blood vessel walls),
High-sensitivity C-reactive proteinA protein found in the blood. Raised levels suggest tissue damage or necrosis (death of cells). (CRPAn abbreviation for C-reactive protein, found in the blood. Raised levels of this protein suggest tissue damage or necrosis (death of cells)., a measure of inflammationThe body’s response to injury.), and
Family history of CHD.
Until this study there has been no good comparison of how well these tools performed. So, The Study used a data set that allowed allowed the researchers to do direct comparisons. They found the CAC score was the best at predicting which of the intermediate risk group would go on to develop CHD over an average follow-up of 7.5 years.