Prevention of heart disease in women with non-traditional risk factors and high calcium scores

Associate Professor Sarah Zaman, University of Sydney

2020 Women and Heart Disease Strategic Grant

Years funded: 2021-2024

Almost half a million Australian women suffer from coronary heart disease, a largely preventable condition with initiation of the right medications and lifestyle changes. However, the key is finding at-risk women, early in life. Currently, doctors rely on risk calculators, that determine 5-year heart attack risk. However, nearly all younger women fall into a low-risk category, despite many having a more than 1 in 3 chance of developing heart disease later in life. These calculators do not consider ‘non-traditional’ risk factors, unique to women, such as pregnancy-related pre-eclampsia, inflammatory conditions and premature menopause. A simple CT-scan can measure heart artery calcification. A CT ‘calcium score’ of zero means a very low chance of heart attack or death, while the presence of heart artery calcium signifies high risk. We will study 414 women (aged 30-65 years) from 4 Australian sites, who are at low-intermediate risk of heart disease with female-specific nontraditional risk factors. Women will be randomly allocated to either standard care, or to undergo a calcium score, with half of these women also receiving a digitally-enhanced support and education package. This clinical trial will show us how many young to middle-aged women with non-traditional risk factors have early-onset heart disease. It will also show us if a calcium score in women can improve cardiovascular risk factors such as cholesterol levels. This clinical trial has the potential to revolutionise prevention of heart disease in young and middle-aged women, ultimately reducing heart attacks, stroke and death.