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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EBased on 2003 mortality data, 1 in 3 women are at risk for cardiovascular disease (CVD); this\ntranslates into more lives claimed by CVD than the next 5 leading causes of death combined.\nCurrently, the best tool available for estimating a woman\u0027s risk factor is the Framingham\nRisk Score, yet most women under 70 years of age are classified as low risk using this method. These\nobservations have prompted clinicians to incorporate other factors, such as family history and\nobesity (not considered in the Framingham Risk Score), to predict overall risk. Additionally, there\nhas been recent interest in identifying novel risk markers that improve traditional risk factor\nassessment in a cost effective way.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eprevention \u0026amp; screening\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EBased on 2003 mortality data, 1 in 3 women are at risk for cardiovascular disease (CVD); this\ntranslates into more lives claimed by CVD than the next 5 leading causes of death combined.\nCurrently, the best tool available for estimating a woman\u0027s risk factor is the Framingham\nrisk score, yet most women under 70 years of age are classified as low risk using this method. These\nobservations have prompted clinicians to incorporate other factors, such as family history and\nobesity (not considered in the Framingham risk score), to predict overall risk. Additionally, there\nhas been recent interest in identifying novel risk markers that improve traditional risk factor\nassessment in a cost effective way.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EExercise testing can improve risk reduction in asymptomatic women\u003C\/h2\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EPhysical fitness has long been known to reduce all-cause mortality from a plethora of diseases,\nmost notably CVD and cancer. Investigators sought to determine if fitness tests could predict heart\ndisease in asymptomatic women. In a study of 2,994 North American asymptomatic women aged 30 to 80,\nexercise capacity and heart rate recovery (HRR) was tested and correlated with cardiovascular and\nall-cause mortality (Mora S. \u003Cem\u003EJAMA\u003C\/em\u003E 2003; 290:1600). After age-adjustment, women who\nwere below the mean for exercise capacity and HRR had a 3.5-fold increased risk of cardiovascular\ndeath compared to women who had above average values for both tests. This large increase in risk\njustifies the use of exercise testing and HRR in predicting CVD in asymptomatic women, combined with\ntraditional risk factors.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EOther non-traditional markers improve risk prediction in women\u003C\/h2\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ERecent data has suggested that plaque burden can be predictive of CAD risk. In a cohort of 10,377\nasymptomatic women, calcium scores \u0026gt;1000 were 4.03 times more likely to experience\nCVD-related death as women whose calcium scores were \u0026lt;10 (Shaw LJ. \u003Cem\u003ERadiology\u003C\/em\u003E\n2003; 228:826). Additional factors demonstrating promising correlations with increased risk of CV\nevents are levels of the inflammatory marker C-reactive protein, the ankle brachial index\n(measurements of blood pressure in the ankle and the arm) and carotid-artery media and intima\nthickness. The ongoing MESA trial (Multi-Ethnic Study of Atherosclerosis), involving over 6,000 men\nand women between the ages of 45 and 84, will likely help us better understand the importance of\nsub-clinical disease measures in preventing CVD events, especially in women.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-4\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ECost considerations in CVD screening\u003C\/h2\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EThe cost of CVD and stroke in the United States in 2006 is projected to be $403.1 billion\nincluding direct and indirect costs, according to the Centers for Disease Control and Prevention.\nThe use of screening tests to decrease this economic burden is therefore attractive, as long as the\nscreening strategies succeed. Possible reasons why a screening strategy might fail are: clinicians\ndo not act on screening results, available therapy may be ineffective, or real-world application of\ntherapy may not yield expected results. Conversely, there is also the possibility that screening\nstrategies may themselves improve adherence to clinical guidelines, observes Vera Bittner, MD,\nProfessor of Medicine from the University of Alabama in Birmingham. Currently, however, there is\ninsufficient data on the benefits of screening methods for CVD. In the future, studies must\ncorrelate screening tests not only to increases in risk, but to actual health benefits.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2006 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/6\/5\/32.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm4wq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}