Navigation Links
Assessing the real risk of heart disease in young people with low short-term risks
Date:1/27/2009

Risk stratification has become central to strategies for the prevention of coronary heart disease, with the implication that priority is given to those at highest risk (ie, those with established heart disease). However, such stratification using the conventional risk estimation models may not be accurately achieved in individuals without symptoms, especially those in younger age groups whose 10-year "short-term" estimated risk seems low.

For example, while the Framingham Risk Score is acknowledged as "a great advance" in the estimation of risk (and thus in the primary prevention of CHD), most younger individuals and virtually all women are defined as low risk, despite apparent and significant differences in their actual risk factor burden.

Now, a new study reported online by Circulation suggests that many younger individuals defined as low risk by conventional risk stratification methods may not remain at low risk throughout their lives.(1)

The study included 2988 individuals under 50 years of age from the Coronary Artery Risk Development in Young Adults (CARDIA) study and 1076 from the Multi-Ethnic Study of Atherosclerosis (MESA). Short-term (10-year) risk was assessed according to the Framingham Risk Score, but added to this risk assessment model were other factors indicative of a longer lifetime risk.(2) Combination of the two risk assessment models allowed risk stratification in three groups: low 10-year/low lifetime risk; low 10-year/high lifetime risk; and high 10-year risk or diagnosed diabetes mellitus. Baseline levels and change in levels of subclinical atherosclerosis (as represented by coronary artery calcium or carotid intima-media thickness) were then compared across the three risk groups. And results showed that those in the low 10-year/high lifetime risk group had a greater subclinical disease burden and greater incidence of atherosclerotic progression than those in the low 10-year/low lifetime risk group, even at younger ages.

"Thus, long-term risk estimates in younger patients may provide new information regarding risk prediction that is not usually available using only a 10-year risk model," said the study's first author Dr Jarrett Berry from UT Southwestern Medical Center, Dallas.

The main weakness of a conventional risk estimation model such as the Framingham Risk Score is the dominance of age, says cardiologist Professor Wolfgang Knig from the University of Ulm Medical Centre in Germany speaking on behalf of the European Society of Cardiology. "It means that 90 per cent of people of a relatively younger age are defined as low risk. But experience tells us that a low short-term risk in younger subjects may not reflect their true risk. We see many young patients with an apparently low short-term risk who actually have advanced heart disease. That's why young patients are still a challenge in cardiology."

Professor Knig adds that the study raises an attractive concept in risk stratification which may well provide a mechanistic explanation for the discrepancy between "low risk" but advanced disease in young people. In public health terms, such an approach may well allow more precise differentiation between various risk groups. "The earlier we can identify risk, the higher the chance of preventing serious disease," he says.


'/>"/>

Contact: ESC Press Office
press@escardio.org
33-049-294-8627
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Assessing the quality of phase I clinical trial abstracts
2. Diabetes Spectrum Reports a Study Assessing the i-port(R) Injection Port for Administration of Insulin
3. Financing Retiree Health Care: Assessing GASB 45 Estimates of Liabilities
4. Measurements Poor for Assessing Clinical Trials With Children
5. Extremely low dose CT coronary angiography shows promise in assessing cardiac function
6. MedPAC Again Fails to Evaluate Overall Economic Conditions in Assessing SNF Funding Requirements
7. Medusa Medical Technologies Announces Integration of Siren ePCR Suite(TM) with Philips HeartStart MRx Monitor/Defibrillator
8. Some Heart Failure Meds May Raise Fracture Risk in Women
9. Heart Healthy Tips from Dr. Praegers Sensible Foods
10. Jiffy Lube(R) Seeks to Raise $1.5 Million for American Heart Associations Go Red For Women(TM) Movement
11. American Heart Association Clarifies the Role Omega-6 Fatty Acids
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... PawPaws brand pet supplements owned by ... to enhance the health of felines. The formula is all-natural and is made from ... the PawPaws Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract ...
(Date:6/25/2016)... , ... June 25, 2016 , ... Austin residents seeking ... American College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical ... effective treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern ... Laude and his M.D from the David Geffen School of Medicine at UCLA. He ... Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program ...
(Date:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... A ... procedures that most people are unfamiliar with. The article goes on to state that ... but also many of these less common operations such as calf and cheek reduction. ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Sessions in Dallas that it will receive two significant new grants to support ... as PHA marked its 25th anniversary by recognizing patients, medical professionals and scientists ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Research and ... News Issue 52" report to their offering. ... influenza treatment creates a favourable commercial environment for MedImmune to ... patient base that will serve to drive considerable growth for ... would serve to cap sales considerably, but development is still ...
(Date:6/23/2016)... MOUNTAIN VIEW, Calif. , June 23, 2016 ... 9:00 a.m. CST on Thursday, July 7, 2016 , , ... kayla.belcher@frost.com ) , , , , EXPERT PANELISTS:  ... Sciences, Nitin Naik; Senior Industry Analyst, Christi Bird; Senior Industry Analyst, ... The global pharmaceutical industry is witnessing ...
(Date:6/23/2016)... and BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of ... Farma Brasil as the company,s second affiliate in Latin America . ... ... Manager of Astellas Farma Colombia ... ...
Breaking Medicine Technology: