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Framingham Score May Not Spot Lifetime Heart Risk
Date:1/12/2009

by scanning the arteries of the participants. Among those estimated to have a higher lifetime risk, the researchers found a greater amount of calcium deposits in the coronary artery and significantly greater thickening of the carotid artery, the major blood vessel to the brain.

"Those with a higher lifetime risk had a greater burden and greater progression of atherosclerosis," Berry said. Atherosclerosis is the hardening of the arteries that can lead to a heart attack, stroke or other cardiovascular problems.

Berry said the Framingham Risk Score remains an important indicator of short-term risk. But, he added, "We feel that this study emphasizes the role of risk factors and the effect they have across the entire life span."

Dr. Kevin M. Johnson, assistant clinical professor of diagnostic radiology at Yale University, said, "This [new study] is another example of how the Framingham Risk Score leaves room for improvement. This paper is part of a discussion about where the weaknesses are and how we can come up with a better risk estimate."

Johnson was lead author of a report published last week in the American Journal of Roentgenology that showed that the Framingham score did not accurately predict cardiovascular risk in a group of people with no history of coronary heart disease. His study also used blood vessel scans, with computerized tomography showing the amount of potentially clogging plaque in the arteries.

Johnson said a new risk assessment "will incorporate the Framingham ideas, but the way they are counted and thrown into the equation will differ."

Hi-tech imaging could be used to help define risk, but there are problems with its everyday use, such as cost and exposure to radiation, he said.

"The question is how we can put together a scheme in which we use the Framingham risk factors, perhaps with calcium scanning for some people and CT for others," Johnson said. "Events are pushing
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