Discordances among different tools used to estimate cardiovascular risk in postmenopausal women.
BACKGROUND
New cardiovascular disease (CVD) risk factors are being recognized and suggested to be included in CVD risk stratification. High-sensitivity C-reactive protein (hs-CRP) and the metabolic syndrome (MetS) are among these risk factors. However, CVD risk classification may be divergent when using different approaches.


OBJECTIVE
To compare differences in CVD risk estimation using the Framingham risk score (FRS), hs-CRP and the presence of the MetS in a group of 109 postmenopausal women in primary CVD prevention.


METHODS
The FRS and presence of the MetS were determined. CVD risk was evaluated with a cardiovascular point scoring system based on Framingham covariables and hs-CRP values (Women's Health Study [WHS] model). The estimated CVD risks based on hs-CRP levels and the WHS model were compared with the FRS.


RESULTS
Using the FRS, 99% of women (n=108) were determined to have a low CVD risk. The MetS was identified in 39.4% (n=43) of the women. When hs-CRP was used alone to estimate CVD risk, 37.6% (n=41) of women were classified as being at low, 33.9% (n=37) at moderate and 28.4% (n=31) at high CVD risk. With the WHS model, 83.5% (n=91), 14.7% (n=16) and 1.8 % (n=2) of women were classified as being at low, moderate and high CVD risk, respectively.


CONCLUSIONS
A substantial number of postmenopausal women showing evidence of the MetS were not identified by the FRS, even though women with the MetS are at higher risk of CVD. Estimation of risk by hs-CRP is significantly divergent when using conventional hs-CRP cutoff values compared with an integrated use in the WHS model.
Pelletier
Pascal
P
Lipid Research Centre, Centre Hospitalier Universitaire de Québec Research Centre, Quebec, Canada.
Lapointe
Annie
A
Laflamme
Nathalie
N
Piché
Marie-Eve
ME
Weisnagel
Stanley John
SJ
Nadeau
André
A
Lemieux
Simone
S
Bergeron
Jean
J
D000368:Aged; D002097:C-Reactive Protein / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D017698:Postmenopause; D018570:Risk Assessment; D012307:Risk Factors
D002097:C-Reactive Protein