Routine mammograms are widely used to screen women for breast cancer. However, recent research suggests that these mammograms might hold another valuable clue:
they can help predict a woman’s risk of experiencing major cardiovascular problems, such as heart attacks and strokes.
This potential discovery could revolutionize how we assess and prevent heart disease in women, who have historically been underrepresented in cardiovascular research and risk assessment.
The Cardiovascular Gender Gap
Heart disease is the leading cause of death in the United States, while stroke ranks fifth.
Although overall cardiovascular mortality rates have been declining, these improvements have been more pronounced among men, leaving women under 55 behind.
Addressing this gender gap in cardiovascular health is crucial, and innovative approaches are needed to improve risk assessment for women.
Research Evidence: The Role of Breast Artery Calcification (BAC)
Dr. Thara Ali, a cardiology fellow at the Geisel School of Medicine at Dartmouth College, led a study that builds upon emerging evidence suggesting that screening mammograms may serve as a useful tool for predicting cardiovascular risk.
This is due to the detection of breast artery calcification (BAC), a previously overlooked sign of potential heart problems.
During a ten-year follow-up period, researchers examined 1,216 women aged 40 to 75 who underwent screening mammograms at Dartmouth Hitchcock Medical Center.
None of these women had coronary artery disease at the beginning of the study.
Remarkably, BAC was detected in one out of every five women, and twice as many women with BAC experienced significant cardiovascular events, including heart attacks, strokes, artery stenting procedures, and death, within a decade compared to those without BAC.
Among women with BAC, 21% later experienced cardiovascular events, compared to only 11% of those without calcification in their breast arteries.
The Superiority of BAC as a Predictor
The study also compared the predictive accuracy of BAC to the current standard for assessing cardiovascular risk in both men and women, the Pooled Cohort Equation.
It revealed that the presence of BAC was a superior predictor of future cardiovascular events, especially among women categorized as low risk by the traditional risk equation.
Eighteen percent of women with BAC experienced cardiovascular events, whereas only 7% of women without breast artery calcification did.
Conclusion: A New Avenue for Cardiovascular Risk Assessment
This study’s preliminary findings suggest that breast artery calcification detected through routine mammograms can be a valuable tool for predicting cardiovascular risk in women.
It provides an opportunity for earlier intervention and prevention strategies, especially for women who might otherwise be classified as low risk by current methods.
However, further research is needed to determine whether BAC’s predictive abilities apply universally across different racial and ethnic groups.
Additionally, the impact of other cardiovascular risk factors on BAC’s predictive accuracy should be explored.
To establish guidelines for reporting BAC and offering proactive prevention strategies, large-scale trials that follow women over time are necessary.
Radiologists, who already identify BAC during mammogram readings, may play a crucial role in initiating discussions with women about modifiable cardiovascular risk factors, such as high cholesterol, high blood pressure, physical inactivity, smoking, or obesity.
While BAC cannot be altered, addressing these risk factors aggressively can significantly reduce the overall cardiovascular risk for women.
In conclusion, routine mammograms have the potential to serve as a powerful tool for predicting heart disease risk in women.
By integrating BAC assessment into cardiovascular risk evaluation, we can work toward closing the gender gap in cardiovascular health and ultimately saving more lives.
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