Women's Health

New Way to Predict Women's Heart Risk

Testing the AHA Guidelines continued...

Another 13% could not be categorized as they lacked risk factors but didn't have good lifestyle habits. That group may need to be addressed in future version of the guidelines, says Hsia.

At the follow-up about eight years later, women in the high-risk group were more likely to have a heart attack or die of coronary disease than were the lower-risk women. While 12.5% of the high-risk women had a heart attack or died from heart disease, 3.1% of the at-risk women did, and just 1.1% of the optimal-risk women did over 10 years.

When Hsia's team compared the new guidelines with the Framingham risk prediction, they found the new guidelines predicted heart problems with accuracy similar to the Framingham categories of less than 10%, 10% to 20%, and over 20%.

The AHA guidelines were less accurate, however, than another Framingham approach, which uses risks of less than 5%, 5% to 20%, and over 20%.

The new guideline, however, ''is more accessible," Hsia says. "It's easier for practitioners to use, easier for patients to understand. I am not saying this [AHA] guideline is preferable to Framingham, but it's worth considering," Hsia tells WebMD.

Based on the risk category, a doctor can then work with the woman to control or eliminate the risk factors.

Second Opinion

''This study is an important validation study to confirm the predictive accuracy of the risk stratification approach," says Cynthia Taub, MD, director of noninvasive cardiology at Montefiore Medical Center in New York.

One strength, she says, is the large number of participants and the relatively long follow-up.

Whether a woman's doctor uses the AHA guideline or the Framingham approach, Taub says it's important that women know their risks. "If you have known coronary artery disease, diabetes, or end-stage or chronic renal [kidney] disease, you are in the high-risk group," she tells patients.

Many risk factors are modifiable, she says, such as smoking, not exercising, and poor diet.

"Stop smoking, become active, improve your diet, and discuss with your doctor how to effectively manage your hypertension and high cholesterol," she advises.