Harvard Heart Letter

Calculating your heart attack risk

The original tool for estimating an individual's heart attack risk was the Framingham score. It uses six items — age, gender, total cholesterol, HDL cholesterol, smoking status, and systolic blood pressure — to calculate the odds of having a heart attack over the next 10 years.

An interdisciplinary team at the Harvard School of Public Health built a more extensive tool called Your Disease Risk (now housed at Washington University School of Medicine in St. Louis). In addition to gauging your chances of having a heart attack — and offering tips on reducing your risk — it does the same thing for having a stroke or developing cancer, diabetes, or osteoporosis.

The new kid on the block is the Reynolds Risk Score. It adds two important pieces of information to the Framingham score — family history of heart disease and the results of a C-reactive protein (CRP) test. Two new studies (Ridker, New England Journal of Medicine 2008 and Wilson, Circulation: Cardiovascular Outcomes and Quality 2008) show that adding data about CRP refines and improves the Framingham score.

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