How accurate is the famous Framingham Risk Score (FRS)? … not very. The best screening tool is a CT scan that additionally measures calcium deposits in the coronary 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 artery calcium (CAC),
- Carotid intima-media thickness (a measure of the thickness of the lining of the carotid artery),
- Ankle-brachial index (ratio of blood pressure in lower legs to blood pressure in arms),
- Brachial flow-mediated dilation (measure of health of the lining of blood vessel walls),
- High-sensitivity C-reactive protein (CRP, a measure of inflammation), 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.
For further information and insight into the latest cardiac diagnostic methods click here to read Prof Avijit Lahiri's article.
