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May 04, 2012

A Comparison of Heart Disease Risk Models

Accounting for new markers of heart health helps doctors better assess your cardiovascular risk.

There are two models that experts use to assess one’s risk for heart disease: the Framingham Risk Score and the Reynolds Risk Score. Although both models are approved and endorsed by the American Heart Association and American College of Cardiology, there are a few differences between them. The Framingham risk model accounts for traditional cardiovascular risk factors, including age, blood pressure, cholesterol, diabetes and smoking. The Reynolds score, on the other hand, accounts for these risk factors along with a few additional markers of heart health, including family history, inflammation and blood sugar levels among diabetics.

Because of these differences, researchers recently compared them to see which test is more accurate in assessing risk for heart disease. After comparing 10-year risk for more than 2,000 female participants from various ethnic backgrounds, researchers found that not only was the Reynolds Risk Score more accurate than the Framingham Risk Score, it had improved accuracy among black and white women.

Based on these findings, it is important to take into account “newer” risk factors for heart disease, including an important marker for inflammation, high-sensitivity C-reactive protein (hsCRP), A1c blood sugar levels among diabetics and family history. Although they are not considered traditional cardiovascular risk factors, testing these markers better equips doctors to assess risk levels more accurately. However, this should not take away from the importance of traditional cardiovascular risk factors—age, blood pressure, cholesterol—in the Framingham risk model. Traditional risk factors are important indicators of heart health and controlling or reducing these risk factors remain key to minimizing risk for heart disease.

Questions for You to Consider

  • Why were only women participants included in this study comparing cardiovascular risk models?

  • This study included only female participants because cardiovascular risk models were developed based on white men primarily, and a few white women. To test the accuracy of both tests, researchers included women from a variety of ethnic backgrounds to see how the tests measure up among these minorities.
  • What is a high-sensitivity C-reactive protein (hsCRP)?
  • C-reactive protein is a type of protein that the liver makes in response to inflammation in the body. Because inflammation is linked with heart disease, doctors often use a simple blood test called a high-sensitivity C-reactive protein test to better assess an individual’s heart health.


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