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Better Ways to Predict Heart Attacks Under Study
Dec. 1, 2004 - For far too many senior citizens, the first
sign of heart disease is frightening chest pain, a rip-roaring heart
attack, or a stroke. Why don't doctors have the equivalent of that old
trick seen in countless Westerns putting an ear to the train tracks to
listen for the approach of the distant train? That question was raised
recently when a prominent American not previously diagnosed with heart
disease President Clintonhad bypass surgery. The December issue of the
Harvard Heart Letter looks at the trusted standby of heart disease risk
assessment the Framingham score and newer tests that may (or may not)
improve or supplant it.
The Framingham risk score comes from the legendary,
long-running Framingham Heart Study. It uses information such as
cholesterol levels, blood pressure, smoking, age, and diabetes to gauge
an individuals chance of having a heart attack in the next 10 years.
(For an online Framingham risk calculator, go to
http://hin.nhlbi.nih.gov/atpiii/calculator.asp.)
Researchers around the country and around the world
are working to refine or replace the Framingham risk score. The December
Harvard Heart Letter explores some of these possibilities, including
C-reactive protein (CRP). This marker of
inflammation the same process that triggers a fever or causes swelling
could be involved in the artery-clogging process of atherosclerosis. A
simple blood test for CRP may help spot people at high risk for a heart
attack or stroke.
Cholesterol "fingerprint". Once there was just total cholesterol to
worry about. Then we learned about bad cholesterol (LDL) and good
cholesterol (HDL). Now it turns out that there are other types, and
measuring them might offer more accurate predictions about heart disease
risk.
Blood sugar. The average amount of sugar in the bloodstream, measured
by a simple blood test for sugar-coated hemoglobin could help identify
people at high or low risk for heart disease.
Heart scans, stretchy arteries, and beyond. A host of other tests that
look directly at the heart and arteries could someday offer an even
clearer window into heart health.
The Harvard Heart Letter is available from Harvard
Health Publications, the publishing division of Harvard Medical School.
You can subscribe for $28 per year at
http://www.health.harvard.edu/heart
or by calling 1-877-649-9457.
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