Researchers are recommending an upgrade in a widely used scoring system to ensure better heart disease diagnosis in women. The researchers suggest leveraging big data and incorporating machine learning to improve the Framingham Risk Score system. Experts say medical professionals as well as women themselves tend to ignore cardiovascular disease symptoms in females. The scoring system used to predict a person’s risk of cardiovascular disease needs to get an upgrade to ensure it accounts for risk factors specifically affecting women. The current design of the FRS means multiple cardiovascular conditions are overlooked and under-diagnosed in women. Improving the diagnosis for women involves leveraging large data sets and incorporating machine learning into the FRS.
According to a study published in the journal Frontiers in Physiology, the Framingham Risk Score (FRS) analyzes six factors to determine a person’s likelihood of experiencing a heart attack or stroke within the next 10 years. While the system does account for gender, researchers say it has never considered the more specific factors within the female body that significantly affect their risk of heart attack or stroke. The lack of sex-specific diagnostic criteria is a major contributor to the under-diagnosis of cardiovascular diseases in women. When it comes to cardiovascular diseases, the prevalence is higher in men than women, yet women are less likely to be diagnosed during routine exams, leading to under-diagnosis and delayed detection. The researchers suggest leveraging large data sets as well as incorporating machine learning into the FRS to help improve the diagnosis for women.
Heart disease kills more women each year than all cancers combined, yet misconceptions continue to portray heart attacks as a risk primarily in men. This perpetuated misconception means that even women may not believe they are at risk for a heart attack. Symptoms of a heart attack in women can be subtler and include shortness of breath, reflux, nausea, vomiting, and a sensation of tightness in the chest. These symptoms can be dismissed as indigestion or anxiety, leading to delays in treatment and potentially more severe complications. Improving the FRS to account for gender-specific risk factors could help change perceptions and lead to better healthcare outcomes for women.
Dr. Evelina Grayver, a cardiologist and director of Women’s Heart Health at Central Region Northwell Health in New York, emphasizes the importance of recognizing women’s unique risk factors when it comes to heart health. Physiological and anatomical differences between men and women mean that traditional risk calculators may not accurately assess a woman’s risk of heart attack. Non-traditional risk factors such as estrogen levels, pregnancy complications, autoimmune diseases, family history, depression, and breast tissue can all play a significant role in determining a woman’s risk of heart disease. Complications during pregnancy, such as preeclampsia and gestational diabetes, can also indicate a woman’s risk of experiencing a heart attack. Grayver believes that incorporating these factors into risk assessment tools can lead to earlier detection and better preventive care for women.
Grayver highlights the importance of considering a woman’s breast calcium score as an indicator of predisposition to cardiovascular disease. Mammogram results should be part of the discussion when reviewing a woman’s overall health, especially her heart health. Grayver hopes that the gender-specific evolution within the FRS will lead to a shift in how society and healthcare professionals view a woman’s risk of heart attack. Healthcare professionals should not dismiss a woman’s symptoms or assume they are related to anxiety. Improving the Framingham Risk Score to account for specific risk factors affecting women can pave the way for personalized medicine and better healthcare outcomes for female patients. The conversation around women’s heart health should start at the same time as routine mammograms, leading to earlier cardiovascular support and better overall health outcomes for women.