title: Different tools for estimating cardiovascular risk in Brazilian postmenopausal women.
abstract: OBJECTIVE
  To compare estimation of cardiovascular risk using the Framinghan Risk Score (FRS) and the presence of the metabolic syndrome (MetS) in postmenopausal women to prevent primary cardiovascular disease (CVD).
  
  
  METHODS
  This cross-sectional study included 497 Brazilian women (aged ≥45 years and amenorrhea >12 months). Cardiovascular risk was calculated using the FRS that includes age, total cholesterol, HDL, systolic blood pressure and smoking status. Women showing three or more of the following criteria were diagnosed with MetS: waist circumference (WC) >88 cm, blood pressure ≥130/85 mmHg, triglycerides ≥150 mg/dl, HDL < 50 mg/dl and glucose ≥100 mg/dl. For statistical analysis, the Chi-square, Fisher's exact, and logistic regression (odds ratio-OR) were used.
  
  
  RESULTS
  The mean age was 55.3 ± 7.0 years and time since menopause 7.2 ± 5.9 years. Based on FRS, 72.4% of women were classified as low-risk, 16.5% moderate risk and 11.1% a high-risk. MetS was identified in 40% of the women, and 46.2% were considered of moderate risk for CVD, while 84.9% of those without MetS were classified as low-risk (p < 0.001). The risk for CVD increased significantly with age at menopause (OR1.10; 95% CI, 1.04-1.17), time since menopause (OR1.13; 95% CI, 1.08-1.18), elevated triglycerides (OR1.03; 95% CI, 1.0-1.10) and presence of MetS (OR1.72; 95% CI 1.48-1.84).
  
  
  CONCLUSIONS
  By using only FRS to estimate cardiovascular risk, a substantial number of postmenopausal women showing evidence of MetS were not identified, even though women with MetS are at higher risk of CVD.
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University, Botucatu, Sao Paulo, Brazil. epetri@fmb.unesp.br
authors.forename: Eliana A P
authors.initials: EA
authors.lastname: Nahas
authors.forename: Aline M
authors.initials: AM
authors.lastname: Andrade
authors.forename: Mayra C
authors.initials: MC
authors.lastname: Jorge
authors.forename: Claudio L
authors.initials: CL
authors.lastname: Orsatti
authors.forename: Flavia B
authors.initials: FB
authors.lastname: Dias
authors.forename: Jorge
authors.initials: J
authors.lastname: Nahas-Neto
mesh_terms: D000368:Aged; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D008055:Lipids