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FRE tests 'unreliable'

Date published: 19/12/2005

Traditional risk-factor scoring is failing to identify one-third of women likely to develop coronary heart disease (CHD), a new study has revealed. Researchers from the Johns Hopkins University in the US have made the discovery as part of an assessment of the Framingham Risk Estimate (FRE) ? the principal test for early detection of heart disease.

FRE calculates how likely a person is to suffer from cardiovascular events based on age, blood pressure, blood cholesterol levels and smoking. However, the latest study has revealed that women with potential cardiovascular diseases are going undetected.
The researchers compared the FRE results of 2,447 women with cardiac CT scans, which measure the build-up of calcium in the arteries. Results revealed that one-third of women classified as low-risk using the FRE test were found to have coronary atherosclerosis.

"We wanted to verify if the Framingham score truly captured who was most at risk, but it turns out to have underestimated a large number of those who should be considered for preventive therapies," said lead researcher Dr Roger Blumenthal.

However, the team claims CT scans for all patients are not generally a practical option, and so devised a system to predict which would be more at risk of calcium build-up. They found that, regardless of a low-risk FRE score, patients with more than two risk factors, such as obesity, smoking and a family history of heart disease, were more likely to have high calcium levels.

"Our results show that if a CT scan had not been performed in addition to traditional risk-factor scoring, a large number of women would have missed the chance to begin preventive therapies," said researcher Dr Erin Michos.

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