A new study published in the July/August 2008 issue of Journal of Women's Health highlights the importance of women knowing their own risk factors for cardiovascular disease, and cautions that a frequently used risk assessment tool could lead to false reassurance that a woman is at low risk for heart problems.

The study is based on the evaluation of 8,936 women screened for heart-health risks at the 2006 Sister to Sister National Woman's Heart Day events in 14 major U.S. cities. The screening included identification of cholesterol levels, blood glucose levels, blood pressure, body mass index and/or measurement of waist circumference, as well as a standardized questionnaire designed to gather demographic data, individual and family medical history, and use of medication.

Most of the women studied showed a high prevalence of one or several risk factors for heart disease. Forty percent had low levels of the good cholesterol (HDL) and 27% had elevated levels of the bad cholesterol (non-HDL). More than half had elevated blood pressure or pre-hypertension. Three quarters were deemed overweight or obese. Nearly half of the women were unaware of the association between risk factors such as high blood pressure and their own risk of developing cardiovascular disease. Many women were unaware of their risk factors at the time of their screening.

A Framingham Risk Score, a frequently used predictor for future heart problems, was calculated for each participant. By that measure, 85% of the participants without a previous history of cardiovascular disease were considered at low risk for a "hard" coronary heart disease event within the next ten years.

But the study authors found that nearly one in five of women with a low risk Framingham score had three or more risk factors for heart problems, with obesity being the most prevalent. This puts these women at increased lifetime risk for cardiovascular disease.

A Framingham low-risk score "can potentially lead to false reassurance and may lower motivation to engage in lifestyle modifications," the article said.

Obesity is a significant risk factor for cardiovascular disease. It also can lead to the development of diabetes, hypertension, osteoarthritis, gall bladder disease, liver disease and many cancers. Studies have demonstrated that active women have lower risk for heart disease than inactive women and that even light to moderate regular activity, combined with a healthy diet, can reduce those risks.

The Journal study pointed out that women account for more than half of the nearly one million cardiovascular deaths per year in the United States. But many women do not realize they are at risk for heart disease, and their physicians may not treat their risk factors as aggressively as they should, the study reported. Since more than 25% of sudden cardiac death occurs among individuals with no prior symptoms of cardio-vascular disease, early identification of heart-health risk factors and preventive action such as life-style changes are of utmost importance.

The identification of multiple risk factors in women participating in this study demonstrates the value of screening events such as the Sister to Sister Foundation free heart health fairs. The study emphasizes the importance of "knowing one's numbers" and making changes in habits and lifestyle to reduce the risk factors for heart disease.

Follow-up with a limited number of study participants indicated that many of them took action to reduce their cardiovascular risks identified at the Sister to Sister screening. More than 70% went to a doctor's office for follow-up care, nearly two-thirds changed their diet, nearly half lost weight and more than three in five increased their physical activity. The Sister to Sister Foundation, however, pointed out that the data from this study of women who chose to attend a heart health fair may not be representative of the overall general population.

Authors of the study include Dr. Roger S. Blumenthal, professor of Medicine and director of The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, in Baltimore, Md., senior author Dr. Erin D. Michos, also a faculty cardiologist at the Johns Hopkins Ciccarone Center, and Dr. Irene Pollin, Ph.D., M.S.W., founder and president of the Sister to Sister: Everyone Has a Heart Foundation based in Chevy Chase, Md.

Dr. Pollin, author of two books, "Medical Crisis Counseling" and "Taking Charge: Overcoming the Challenges of Long-Term Illness," has a Master of Social Work degree from Catholic University, an Honorary Doctorate of Humanities degree from Howard University, and is a member of the Harvard University School of Public Health Nutrition Round Table, Howard University's Women's Health Institute Advisory Committee, and the Columbia Presbyterian Health Sciences Advisory Council.

"Our goal at Sister to Sister is to emphasize how vital it is for women to be adequately screened for potential cardiovascular disease," she said. "It is critical not only for women but for their families because they typically are the household decision-makers about diet and exercise."

Journal of Women's Health, published by Mary Ann Liebert, Inc. (liebertpub) is a core multidisciplinary journal dedicated to the diseases and conditions that hold greater risk for or are more prevalent among women. The Journal covers the latest advances and clinical applications of new diagnostic procedures and therapeutic protocols for the prevention and management of women's healthcare issues. A complete copy of the study is available free for 30 days at liebertonline/doi/pdfplus/10.1089/jwh.2007.0640

Sister to Sister is a 501(c)(3) foundation that is dedicated solely to bringing free heart disease screenings and "heart-healthy" information and support to women to prevent heart disease. For more information, visit sistertosister

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