Framingham Score May Not Spot Lifetime Heart Risk

Study is third in a week to question some facet of the widely used guideline

By Ed Edelson
HealthDay Reporter

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MONDAY, Jan. 12 (HealthDay News) -- As many as half of people aged 50 and younger who have a low 10-year risk of heart attack or stroke based on the widely used Framingham Risk Score may still have a high lifetime risk.

That's the conclusion of a new study published in the Jan. 13 issue of Circulation. It's the third study published in the last week to question the Framingham Risk Score's ability to accurately predict cardiovascular risk among all people.

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The new study specifically found that the Framingham Risk Score may be good at predicting the 10-year probability of heart attack or stroke for people younger than 50, but it falls short at assessing longer-term risk.

The Framingham score is based on a decades-long study in that Massachusetts community. It assesses the risk of cardiovascular events such as heart attack and stroke on the basis of seven factors -- age, gender, total blood cholesterol, HDL (good) cholesterol, systolic blood pressure (the higher of the desired 120 over 80 reading), smoking status, and whether blood pressure medication is being taken.

For the new study, 90 percent of the almost 4,000 participants -- all 50 or younger -- were classified as having a low 10-year risk of cardiovascular disease, based on the Framingham criteria. But a careful look at the risk factors other than age divided the participants into two groups -- those having either a low or a high lifetime risk, said study lead author Dr. Jarrett D. Berry, at assistant professor of medicine at the University of Texas Southwestern Medical Center at Dallas.

The differences in the classic risk factors such as cholesterol levels and blood pressure "were very significant in terms of long-term risk, even though we don't see those differences in short-term risk," Berry said.

The researchers then verified their estimates 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.

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