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Exercise Testing, Family History, and Subclinical Atherosclerosis Markers for Cardiovascular Risk Reclassification in Middle-Aged Women
Coutinho, Ricardo Quental; Montarroyos, Ulisses Ramos; Barros, Isly Maria Lucena de; Guimarães, Maria José Bezerra; Leão, Ana Paula Dornelas; Costa, Laura Olinda Bregieiro Fernandes; Medeiros, Ana Kelley de Lima; Monteiro, Maria de Fátima; Ferreira, Moacir de Novaes Lima; Chalela, William Azem; Pedrosa, Rodrigo Pinto.
  • Coutinho, Ricardo Quental; Universidade de Pernambuco. Recife. BR
  • Montarroyos, Ulisses Ramos; Universidade de Pernambuco. Recife. BR
  • Barros, Isly Maria Lucena de; Universidade de Pernambuco. Recife. BR
  • Guimarães, Maria José Bezerra; Universidade de Pernambuco. Recife. BR
  • Leão, Ana Paula Dornelas; Universidade de Pernambuco. Recife. BR
  • Costa, Laura Olinda Bregieiro Fernandes; Universidade de Pernambuco. Recife. BR
  • Medeiros, Ana Kelley de Lima; Universidade de Pernambuco. Recife. BR
  • Monteiro, Maria de Fátima; Universidade de Pernambuco. Recife. BR
  • Ferreira, Moacir de Novaes Lima; Universidade de Pernambuco. Recife. BR
  • Chalela, William Azem; Universidade de São Paulo. São Paulo. BR
  • Pedrosa, Rodrigo Pinto; Universidade de Pernambuco. Recife. BR
Int. j. cardiovasc. sci. (Impr.) ; 34(4): 383-392, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286828
ABSTRACT
Abstract Background Cardiovascular diseases are the main cause of death in women and the accuracy of currently available risk scores is questionable. Objective To reclassify the risk estimated by the Framingham Risk Score (FRS) in asymptomatic middle-aged women by incorporating family history, exercise testing variables, and subclinical atherosclerosis markers. Methods This cross-sectional study included 509 women (age range, 46-65 years) without cardiovascular symptoms. Those at low or intermediate risk by the FRS were reclassified to a higher level considering premature family history of acute myocardial infarction and/or sudden death; four variables from exercise testing; and two variables related to subclinical atherosclerosis markers. The homogeneity of these variables according to the FRS was verified by Pearson chi-square test (p<0.05). Results According to the FRS, 80.2%, 6.2%, and 13.6% of the women were classified as low (<5%), intermediate (5-10%), and high (>10%) risks, respectively. The intermediate-risk stratum showed the highest increase (from 6.2% to 33.3%) with addition of family history; followed by addition of chronotropic index <80% (to 24.2%); functional capacity <85% (22.2%), coronary calcium score >0 (20.6%); decreased one-minute heart rate recovery ≤12 bpm (15.2%); carotid intima-media thickness >1 mm and/or carotid plaque (13.8%) and ST-segment depression (9.0%). The high-risk stratum increased to 14.4% with the addition of reduced heart rate recovery and to 17.1% with the coronary calcium score. Conclusion Incorporation of premature family history of cardiovascular events, exercise testing abnormal parameters, and subclinical atherosclerosis markers into the FRS led to risk reclassification in 3.0-29.7% of asymptomatic middle-aged women, mainly by an increase from low to intermediate risk.
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Full text: Available Index: LILACS (Americas) Main subject: Heredity / Atherosclerosis / Exercise Test / Heart Disease Risk Factors Type of study: Etiology study / Observational study / Prevalence study / Risk factors Limits: Female / Humans Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de Pernambuco/BR / Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Heredity / Atherosclerosis / Exercise Test / Heart Disease Risk Factors Type of study: Etiology study / Observational study / Prevalence study / Risk factors Limits: Female / Humans Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2021 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de Pernambuco/BR / Universidade de São Paulo/BR