Featured Research

from universities, journals, and other organizations

Assessing The Real Risk Of Heart Disease In Young People With Low Short-term Risks

Date:
February 4, 2009
Source:
European Society of Cardiology (ESC)
Summary:
Risk stratification has become central to strategies for the prevention of coronary heart disease. However, stratification using the conventional risk estimation models may not be accurately achieved in individuals without symptoms. A new study suggests that many younger individuals defined as low risk by conventional risk stratification methods may not remain at low risk throughout their lives.

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 König 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 König 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.


Story Source:

The above story is based on materials provided by European Society of Cardiology (ESC). Note: Materials may be edited for content and length.


Journal Reference:

  1. Berry et al. Prevalence and Progression of Subclinical Atherosclerosis in Younger Adults With Low Short-Term but High Lifetime Estimated Risk For Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults Study and Multi-Ethnic Study of Atheroscleros. Circulation, 2009; 119 (3): 382 DOI: 10.1161/CIRCULATIONAHA.108.800235

Cite This Page:

European Society of Cardiology (ESC). "Assessing The Real Risk Of Heart Disease In Young People With Low Short-term Risks." ScienceDaily. ScienceDaily, 4 February 2009. <www.sciencedaily.com/releases/2009/02/090202140654.htm>.
European Society of Cardiology (ESC). (2009, February 4). Assessing The Real Risk Of Heart Disease In Young People With Low Short-term Risks. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2009/02/090202140654.htm
European Society of Cardiology (ESC). "Assessing The Real Risk Of Heart Disease In Young People With Low Short-term Risks." ScienceDaily. www.sciencedaily.com/releases/2009/02/090202140654.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) — Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) — The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) — A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) — All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins