Reynolds Risk Score

Frequently Asked Questions

What if I have diabetes?

Women/Men with diabetes should not use the Reynolds Risk Score as they are already considered to be a high-risk group for both heart disease and stroke. Women/Men with diabetes should talk with their physicians about risk-reduction programs that emphasize weight loss, diet, and exercise, and possible medical therapies.

What is C-reactive protein and why is it part of the Reynolds Risk Score?

C-reactive protein is a marker of inflammation that can be measured in the blood along with cholesterol levels. When measured with a high-sensitivity blood test known as "high-sensitivity C-reactive protein" or "hsCRP", levels of this protein provide information about risk of heart disease and stroke that adds information about overall risk. Diet, exercise, and smoking cessation all lower hsCRP levels as do some medications used to control blood pressure and cholesterol levels. Information on the role of CRP in heart disease for both physicians and patients is available from many websites including crphealth.com In general, hsCRP levels less than 1, 1 to 3, and greater than 3 mg/L suggest lower, moderate, and higher relative risk of future heart disease.

Why does family history matter and why is it part of the Reynolds Risk Score?

You can inherit risk for heart disease from either of your parents. The Reynolds Risk Score asks whether or not either of your parents had a heart attack before they reached age 60. This is a useful piece of information that summarizes much of your genetic risk. Some women/men may not know the answer to this question; in that case, we recommend that you calculate your risk twice, once using the "yes" option and once using the "no" option for this question. By doing so, you will get a range of risk, even if you do not know your own family history.

What do I do if my Reynolds Risk Score risk is elevated?

Women/Men at increased risk for heart disease should consult with their physicians about diet, exercise, and smoking cessation. Those with high blood pressure or high cholesterol levels may also need drug treatment. The most important issue is to get a clear understanding of your level of risk so that an effective long-term prevention plan can be initiated.

If I stop smoking, how much will my risk go down?

If you change your answer to "no" for smoking, the Reynolds Risk Score will recalculate your risk for you.

How Do I Improve My Risk Factors?

There are many excellent websites that provide information on risk reduction including sites sponsored by the American Heart Association and the American College of Cardiology . Excellent sites with information specific to women include www.GoRedForWomen.com, www.ChooseToMove.com, www.womenshealth.gov. For specific information on C-reactive protein, patient-friendly information can be obtained at crphealth.com.

Click here

How was the Reynolds Risk Score developed and validated?

The Reynolds Risk Score was developed and validated using data from 24,558 initially healthy American women who were followed over a ten-year period for the development of heart attack, stroke, angioplasty (balloon surgery to open an artery), coronary artery bypass surgery, or death related to heart disease. Full details of the Reynolds Risk Score are published in the Journal of the American Medical Association,(Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: The Reynolds Risk Score. JAMA 2007;297:611-619). Funding for this project was provided by a research grant from the Donald W Reynolds Foundation and by the National Heart Lung and Blood Institute. The Reynolds Risk Score for men was similarly developed using data from 10,724 initially healthy non-diabetic American men who were followed over a ten-year period for the development of heart attack, stroke, angioplasty, bypass surgery, or death related to heart disease. Full details of the Reynolds Risk Score for men are published in Circulation (Ridker PM, Paynter NP, Rifai N, Gaziano JM, Cook NR. C-reactive protein and parental history improve global cardiovascular risk prediction: The Reynolds Risk Score for Men. Circulation 2008 (in press)).

How to enter values for calculator

How to enter total cholesterol: The American Heart Association recommends that total cholesterol values should be the average of at least two measurements obtained from a standard blood test. Total cholesterol, HDL cholesterol and hsCRP can be measured on the same blood sample. Total cholesterol should be reported to you in mg/dL. The typical range for most individuals is between 100 and 400 mg/dL, with higher levels associated with higher risk. For most individuals, an optimal level of total cholesterol is less than 160 mg/dL.

How to enter HDL or "good" cholesterol: The American Heart Association recommends that HDL or "good" cholesterol values should be the average of at least two measurements obtained from a standard blood test. Total cholesterol, HDL cholesterol and hsCRP can be measured on the same blood sample. HDL cholesterol should be reported to you in mg/dL. The typical range for most individuals is between 10 and 100 mg/dL, with higher levels associated with lower risk. For most individuals, an optimal level of HDL cholesterol is greater than 60 mg/dL.

How to enter systolic blood pressure: The systolic blood pressure value to be used in the Reynolds Risk Score is the upper number from your most recent blood pressure evaluation, regardless of whether you are on blood pressure medications. For example, if your blood pressure is 120/80, then your systolic blood pressure to be used in the Reynolds Risk Score is 120. Systolic blood pressure should be reported in mm/Hg. The typical range for most individuals is between 90 to 190 mm/Hg. For most individuals, an optimal systolic blood pressure is less than 120 mm/Hg.

How to enter hsCRP: The American Heart Association recommends that high sensitivity C-reactive protein (hsCRP) values should be the lower of at least two values obtained from a standard blood test. This is particularly important if the initial hsCRP value is > 5 mg/L. Total cholesterol, HDL cholesterol and hsCRP can be measured on the same blood sample. The typical range for hsCRP is between 0.01 and 10 mg/L, with higher levels associated with higher risk. Some individuals will have very high hsCRP levels on a chronic basis, even after repeat testing. These individuals represent a high risk group so the Reynolds Risk Score will accept hsCRP values up to 50 mg/L. For most individuals, an optimal level of hsCRP is less than 0.5 mg/L.

How to enter smoking status: The Reynolds Risk Score considers a woman/man who has smoked any cigarettes in the last month as a "current smoker".

How to enter parental history of heart disease before age 60: If either your mother or father suffered from a heart attack or stroke before age 60 years, the Reynolds Risk Score considers parental history to be positive.