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News
Gene Variation Impacts Lipid Profile
A new mathematical model should renovate the sorely outdated strategy for predicting cardiovascular disease in women. Much progress has been made in the understanding of the disease processes leading to heart problems in women, yet the models, or algorithms, for assigning risk have been in place for over 40 years.
The development of a new model, by Nancy Cook Sc.D. and colleagues from Brigham and Women’s Hospital in Boston, may catapult the science of predicting women’s coronary risk into the 21st century. The details of the Reynolds Risk Score were published in the February 14, 2007 issue of the Journal of the American Medical Association. The group accounted for recent scientific advances to update the list of potential factors contributing to cardiovascular disease, utilized a large patient population from which to generate new mathematical models to assign risk, and tested the new algorithms in a large group of women.
According to the authors, current risk assignment procedures, which rely on risk factors assigned in the 1960’s, needed remodeling: about 20% of women who experience a cardiovascular event (heart attack, stroke, etc.) had none of the defined risk factors, and many women with traditional risk factors never experience cardiac trouble. They used a large population of over 16,000 women to generate two novel risk models, and used a group of over 8000 women to test the efficiency of the models over 10 years.
They found that the use of these new algorithms resulted in the re-classification of 40-50% of the women in the study (Ridker et al. 2007 JAMA 297). In other words, of women that had been classified in the intermediate risk group, about half of them would be better classified as either low- or high-risk. The enhanced efficiency of the Reynolds Risk Score comes almost entirely from the inclusion of two additional risk factors: parental history and levels of an immune protein called C-reactive protein.
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