A better way to predict stroke and heart attack

University of Western Australia researchers are creating a revised risk assessment procedure to predict whether older men may be heading for their first heart attack or stroke.

The US Framingham risk equation used in most countries is the basis of standard risk prediction tools to determine an individual’s risk.

However, UWA senior lecturer in geriatric medicine and WA Centre for Health and Ageing chief investigator Associate Professor Christopher Beer says the research team set out 10 years ago to assess how useful this equation really is.

The study first comprised a prospective data set from the WA Aneurysm Screening Trial based on 20,000 men randomly selected from the electoral roll.

The study then rolled over to the “Healthy Men” study as participants became older and began suffering stroke or myocardial infarction (MI).

The team assessed 4,382 men from Perth aged 65–83 with no history of stroke or heart attack who were assessed again in 1996, 2004 and 2009.

“We used the baseline clinical variables, demographic factors and medical therapy and looked at the incidence of a predictive event,” Prof Beer says.

“It shows of the traditional risk factors like smoking, hypertension, diabetes, age – only age and smoking remained significantly predictive in this cohort.

“So we looked at co-morbidity, sensory impairment, cognitive impairment, blood pressure, diabetes, respiratory disease, renal function, cholesterol and others.

“Other important factors included diastolic blood pressure, homocysteine levels, C-reactive protein levels (inflammation in the blood) and waist to hip ratio (obesity).”

He says the study confirms other people’s perception and report of their own health can be incorporated into the tool.

“But I don’t think many researchers have thought to use this as a predictive tool as we have.

“We examined the new method against the Framingham equation and the new tool compared favourably.”

Dr Beer says it while it is a simple tool only comprising eight variables, it requires talking to the patient, examining tests and taking body measurements, whereas the Framingham equation does not list all these requirements.

However, he says needs validation in other ethnic populations, aboriginal populations, age groups and in women, as vascular disease predictors are differ greatly between genders.

The paper, “Traditional Risk Factors for Incident Cardiovascular Events Have Limited Importance in Later Life Compared with the Health in Men Study Cardiovascular Risk Score”, is published online in the American Heart Association journal Stroke.

(Source: Science Network WA: Stroke)

More information

For more information on keeping your heart healthy, including information on how the heart works, the effect of cholesterol and eating for heart health, as well as some useful videos and tools, see Heart Health.