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Relation of Framingham risk score to subclinical atherosclerosis evaluated across three arterial sites

Roksana Karim1, Howard N Hodis, Robert Detrano

  • 1Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA. rkarim@usc.edu

The American Journal of Cardiology
|September 23, 2008
PubMed

Insights

The Framingham risk score (FRS) may underestimate cardiovascular risk. Subclinical atherosclerosis is common even in low-risk individuals, suggesting FRS alone may not be sufficient for risk assessment.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Preventive Cardiology

Background:

  • The Framingham risk score (FRS) is a standard tool for assessing coronary heart disease (CHD) risk.
  • Limitations of FRS in accurately identifying all at-risk individuals have been noted.
  • Subclinical atherosclerosis represents early stages of cardiovascular disease.

Purpose of the Study:

  • To evaluate the prevalence of subclinical atherosclerosis across different Framingham risk score (FRS) strata.
  • To determine the association between FRS and measures of subclinical atherosclerosis in multiple arterial sites.
  • To assess the utility of combining FRS with vascular imaging for risk stratification.

Main Methods:

  • 498 healthy subjects underwent vascular imaging to detect subclinical atherosclerosis.
  • Coronary artery and aortic calcification, and carotid intima-media thickness were measured.
  • Subclinical atherosclerosis measures were analyzed across low, intermediate, and high FRS categories.

Main Results:

  • Subclinical atherosclerosis was significantly associated with FRS across all measured arterial sites.
  • Prevalence of subclinical atherosclerosis increased with higher FRS categories.
  • Even in the low-risk FRS group, a significant proportion (69%) exhibited subclinical atherosclerosis.

Conclusions:

  • Subclinical atherosclerosis is prevalent across the entire spectrum of FRS, including low-risk individuals.
  • Integrating vascular imaging of atherosclerosis with FRS may improve identification of individuals needing intervention.
  • This approach could enhance targeted lifestyle and medical interventions for cardiovascular disease prevention.

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