How the Reynolds Score Is Used to Calculate Cardiac Risk in Women

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Several methods have been developed for assessing a person’s risk of developing cardiovascular disease. In 2007, a risk calculator — the Reynolds Score — was validated for women. (A variant of the Reynolds Score was later validated for men, also.)

The Importance of Estimating Your Risk

Accurately estimating cardiac risk is important, because it allows you (and your doctor) to decide how aggressive you ought to be in taking steps to reduce your risk.

For people whose cardiovascular risk is elevated, an aggressive program of risk reduction can substantially lower the odds of death or disability from heart disease or stroke. People who are at intermediate risk also ought to take seriously the steps they can follow to lower their risk.

How the Reynolds Risk Score Is Calculated

The Reynolds Risk Score was originally designed specifically for women, because it was felt that in women it is particularly important to take into account a family history of premature heart disease (which implies a genetic predisposition to cardiovascular disease), and also CRP levels (a marker of inflammation).

The score was developed by following a group of 25,000 healthy American women 45 years old or older (who, in particular, did not have diabetes) for an average of 10 years. The experts who developed the Reynolds score were concerned that standard risk models — in particular, the Framingham score — might not be as accurate in women as they are in men.

For instance, standard risk calculators may fail to classify up to 20% of women who subsequently have heart attacks as being at high risk. By giving more weight to CRP levels and family history, it was theorized, the Reynolds score might be more suitable for women.

The Reynolds score is calculated based on the following risk factors:

  • Age
  • Current smoker (yes or no)
  • Systolic blood pressure
  • Total cholesterol
  • HDL cholesterol
  • CRP level
  • Mother or father with heart attack before age 60 (yes or no)

Notably, diabetes was not included in this risk score. The cardiovascular endpoints used in developing the Reynolds Score for women were cardiovascular death, non-fatal heart attack, non-fatal stroke, or the need for bypass surgery or a stent.

Effectiveness

The Reynolds Risk Score score accurately classified the actual risk of many more women than did the usual predictive models. In fact, 40 - 50% of women who normally would be classified as having intermediate risk were reclassified by the Reynolds Score as either low or high risk — thus potentially allowing a much more targeted approach to risk factor management.

As noted, the Reynolds score originally was specifically developed for women. A similar study has now been conducted in men, and a separate Reynolds Risk Score has now been validated for men.

Use

The Reynolds Risk Score calculator can be found here (for both men and women). It asks several simple questions and immediately returns a 10-year risk score. (That is, it tells you the estimated probability that you will have a cardiovascular event within the next 10 years.) It also allows you to see readily how your risk would be improved if would change one or more of these risk factors.

 

For instance, if you are a smoker you would simply need to enter “no” for the smoking question and the calculator will show you how much your 10-year risk would be reduced if you were to quit.

Note that the Reynolds Risk Score is not meant for people who have diabetes. If you have diabetes your cardiovascular risk is already known to be high, and the Reynolds score can add no additional useful information.

To use the Reynolds risk score calculator, you need to know your blood pressure readings, and several important blood test results: total cholesterol, HDL, and CRP.

A Word From Verywell

The Reynolds Risk Score for women (and also for men) is a risk calculator that places more emphasis on CRP levels and family history than other, more commonly used risk calculators.

Experts who believe CRP to be an important determinant of cardiovascular risk tend to place great importance on the Reynolds Risk Score.

Sources:

Ridker P, Buring J, Rifai N, et al. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women. JAMA 2007; 297: 611-619.

Ridker PM, Paynter NP, Rifai N, et al. C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men. Circulation 2008; 118:2243.

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