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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
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
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
Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to
prevent vascular events in men and women with elevated c-reactive
New England Journal of Medicine 2008; published at
www.nejm.org on November 9, 2008 (10.1056/NEJMoa0807646)
A terrific article on the connection between inflammation and
atherosclerosis was written by Dr. Peter Libby, a professor of
medicine at Harvard Medical School and chief of cardiology at
Brigham and Women's Hospital. It appeared in the May 2002 issue
Scientific American, which the magazine reposted
after the JUPITER results were published.
Making a personal health record can give you and your doctors a
complete picture of your health. It can prevent medical errors or
reduce duplicate tests. In an emergency, it can provide vital
information that may not be immediately available from your
doctors. A good general resource is myphr.com, a Web site sponsored by
the American Health Information Management Association.
A personal health record can store everything from basic
information about you to copies of x-rays and CT scans. At
minimum it should contain:
your name, date of birth, and vital statistics like height
Searching for health information is one of the top things people
do on the World Wide Web. Some want more information than they
can get from their doctor or nurse. Others want to investigate a
symptom, find a new doctor, or track down a new treatment. If you
are new to this, the vast amount of information on the Web can be
like drinking from a fire hose. Harvard Heart Letter
editor Patrick Skerrett demonstrates some good places to start.
The editors of the Harvard Heart Letter introducean issue focused
on acquiring new knowledge in order to improve your health.
Start the year with these tips for heart care and healthier
living. Suggestions include learning CPR, reducing stress,
establishing an advance care directive and choosing a health care
The results of a large trial suggest that people with LDL
cholesterol in the normal range but with a high C-reactive
protein level may benefit from taking a statin. This may lead to
increased use of the CRP to test for heart disease.
Gathering all your health records and vital information in one
place can streamline your care and help doctors in the event of
an emergency. Several web sites now offer ways to simplify the
online storage of health information.
The medical view of atherosclerosis is changing from the
traditional one of arteries blocked by plaque to a more
encompassing one, with inflammation as the main cause and an
emphasis on stopping it before it even starts.
There is plenty of information available online to help you learn
about cardiovascular health, but not all of it is unbiased or
I have coronary artery disease. Is this something I can have
cured or get rid of, or is keeping it from getting worse the best
I can do?
When I am under great stress, my blood pressure sometimes shoots
up to 200/120 but then quickly goes down to 120/80 or lower and
stays there. One doctor told me that spikes like these are
normal. Another told me this isn't healthy. Who is right?
I had an electrocardiogram in preparation for minor surgery. My
doctor told me it showed that I have right bundle branch block.
Neither he nor my cardiologist are worried about it, but I am. Is