Review on Cardiovascular Risk Prediction

Cardiovascular Therapeutics

Volumn 33, Issue 2, 2015, Pages 62-70

  Ruwanpathirana, Thilanga ^a   Owen, Alice ^a   Reid, Christopher M ^a  

^a MONASH UNIVERSITY   (Australia)

Author keywords

Cardiovascular disease; Cost effectiveness; Novel biomarkers; Risk prediction models

Indexed keywords

BRAIN NATRIURETIC PEPTIDE; BIOLOGICAL MARKER;

ARTICLE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; COST; HEART INFARCTION; HUMAN; JOB STRESS; POPULATION RISK; PREDICTION; PRIORITY JOURNAL; RESEARCH PRIORITY; RISK ASSESSMENT; RISK FACTOR; SOCIAL ISOLATION; AGE; BLOOD; CARDIOVASCULAR DISEASES; DECISION SUPPORT SYSTEM; GENETIC PREDISPOSITION; PREDICTIVE VALUE; PREVENTIVE HEALTH SERVICE; PROGNOSIS; RECURRENT DISEASE; SEX DIFFERENCE; SOCIOECONOMICS; TIME;

AGE FACTORS; BIOMARKERS; CARDIOVASCULAR DISEASES; DECISION SUPPORT TECHNIQUES; GENETIC PREDISPOSITION TO DISEASE; HUMANS; PREDICTIVE VALUE OF TESTS; PREVENTIVE HEALTH SERVICES; PROGNOSIS; RECURRENCE; RISK ASSESSMENT; RISK FACTORS; SEX FACTORS; SOCIOECONOMIC FACTORS; TIME FACTORS;

EID: 84925351967     PISSN: 17555914     EISSN: 17555922     Source Type: Journal    
DOI: 10.1111/1755-5922.12110     Document Type: Article

References (113)

1. Cardiovascular diseases (Key Facts - Updated January 2015) Geneva: WHO; [29 January 2015]. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/.
2. Mackay J, Mensah GA. The atlas of heart disease and stroke. Geneva: WHO, 2004 [Accessed 29 January 2015]. Available from: http://www.who.int/cardiovascular_diseases/resources/atlas/en/.
3. Khot UN, Khot MB, Bajzer CT, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA 2003;290:898-904.
4. Cooney MT, Dudina AL, Graham IM. Value and limitations of existing scores for the assessment of cardiovascular risk: A review for clinicians. J Am Coll Cardiol 2009;54:1209-1227.
5. Lloyd-Jones DM. Cardiovascular risk prediction: Basic concepts, current status, and future directions. Circulation 2010;121:1768-1777.
6. van Holten TC, Waanders LF, de Groot PG, et al. Circulating biomarkers for predicting cardiovascular disease risk; a systematic review and comprehensive overview of meta-analyses. PLoS ONE 2013;8:e62080.
7. Greenland P, Smith SC Jr, Grundy SM. Improving coronary heart disease risk assessment in asymptomatic people: Role of traditional risk factors and noninvasive cardiovascular tests. Circulation 2001;104:1863-1867.
8. Grundy SM, Pasternak R, Greenland P, Smith JS, Fuster V. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology 1. J Am Coll Cardiol 1999;34:1348-1359.
9. Pencina MJ, D'Agostino RB, Larson MG, Massaro JM, Vasan RS. Predicting the 30-year risk of cardiovascular disease: The Framingham heart study. Circulation 2009;119:3078-3084.
10. Rapsomaniki E, Shah A, Perel P, et al. Prognostic models for stable coronary artery disease based on electronic health record cohort of 102 023 patients. Eur Heart J 2014;35:844-852.
11. Battes L, Akkerhuis M, Van boven N, Boersma E, Kardys I. Cardiovascular risk prediction models in patients with stable coronary artery disease. Exp Clin Cardiol 2014;20:117-129.
12. Wilson PWF, D'Agostino R Sr, Bhatt DL, et al. An international model to predict recurrent cardiovascular disease. Am J Med 2012;125:695-703. e691.
13. Gilstrap LG, Wang TJ. Biomarkers and cardiovascular risk assessment for primary prevention: An update. Clin Chem 2012;58:72-82.
14. D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: The Framingham heart study. Circulation 2008;117:743-753.
15. Conroy RM, Pyörälä K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur Heart J 2003;24:987-1003.
16. Woodward M, Brindle P, Tunstall-Pedoe H. Adding social deprivation and family history to cardiovascular risk assessment: The ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 2007;93:172-176.
17. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, Brindle P. Predicting cardiovascular risk in England and Wales: Prospective derivation and validation of QRISK2. BMJ 2008;336:1475-1482.
18. Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular münster (PROCAM) study. Circulation 2002;105:310-315.
19. Prevention of Cardiovascular Disease. Guidelines for assessment and management of cardiovascular risk. Geneva, Switzerland: World Health Organization, 2007.
20. 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;118:2243-2251.
21. Ridker P, 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.
22. McGorrian C, Yusuf S, Islam S, et al. Estimating modifiable coronary heart disease risk in multiple regions of the world: The INTERHEART Modifiable Risk Score. Eur Heart J 2011;32:581-589.
23. Backus BE, Six AJ, Kelder JH, Gibler WB, Moll FL, Doevendans PA. Risk scores for patients with chest pain: Evaluation in the emergency department. Curr Cardiol Rev 2011;7:2-8.
24. Maisel AS, Bhalla V, Braunwald E. Cardiac biomarkers: A contemporary status report. Nat Clin Pract Cardiovasc Med 2006;3:24-34.
25. Gray D. Risk assessment gone mad: The rise of risk evaluation and mass public deception. Br J Cardiol 2009;16:117-118.
26. Kurian AK, Cardarelli KM. Racial and ethnic differences in cardiovascular disease risk factors: A systematic review. Ethn Dis 2007;17:143-152.
27. WHO MONICA Project Principal Investigators. The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): A major international collaboration. J Clin Epidemiol 1988;41:105-114.
28. Lee M-S, Flammer AJ, Li J, et al. Time-trend analysis on the framingham risk score and prevalence of cardiovascular risk factors in patients undergoing percutaneous coronary intervention without prior history of coronary vascular disease over the last 17 years: A study from the mayo clinic PCI registry. Clin Cardiol 2014;37:408-416.
29. Melander O, Newton-Cheh C, Almgren P, et al. Novel and conventional biomarkers for prediction of incident cardiovascular events in the community. JAMA 2009;302:49-57.
30. Empana JP, Ducimetière P, Arveiler D, et al. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? Eur Heart J 2003;24:1903-1911.
31. de Lemos JA, Lloyd-Jones DM. Multiple biomarker panels for cardiovascular risk assessment. N Engl J Med 2008;358:2172-2174.
32. Vasan RS. Biomarkers of cardiovascular disease: Molecular basis and practical considerations. Circulation 2006;113:2335-2362.
33. Cook NR. Use and misuse of the receiver operating characteristic curve in risk prediction. Circulation 2007;115:928-935.
34. Kuller LH, Tracy RP, Shaten J, Meilahn EN. Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Am J Epidemiol 1996;144:537-547.
35. Danesh J, Kaptoge S, Mann AG, et al. Long-term interleukin-6 levels and subsequent risk of coronary heart disease: Two new prospective studies and a systematic review. PLoS Med 2008;5:e78.
36. Miwa K, Tanaka M, Okazaki S, Furukado S, Sakaguchi M, Mochizuki H, Kitagawa K. Association between interleukin-6 levels and first-ever cerebrovascular events in patients with vascular risk factors. Arterioscler Thromb Vasc Biol 2013;33:400-405.
37. Alwi I, Santoso T, Suyono S, Sutrisna B, Kresno SB. The cut-off point of interleukin-6 level in acute coronary syndrome. Acta medica Indonesiana 2007;39:174-178.
38. Rehman SU, Mueller T, Januzzi JL Jr. Characteristics of the novel interleukin family biomarker ST2 in patients with acute heart failure. J Am Coll Cardiol 2008;52:1458-1465.
39. McConnell JP, Hoefner DM. Lipoprotein-associated phospholipase A2. Clin Lab Med 2006;26:679-697.
40. Garza CA, Montori VM, McConnell JP, Somers VK, Kullo IJ, Lopez-Jimenez F. Association between lipoprotein-associated phospholipase A2 and cardiovascular disease: A systematic review. Mayo Clin Proc 2007;82:159-165.
41. Zheng D, Zeng F, Cai A, et al. Baseline elevated Lp-PLA2 is associated with increased risk for re-stenosis after stent placement. Lipids Health Dis 2014;13:41.
42. Tuomisto K, Jousilahti P, Sundvall J, Pajunen P, Salomaa V. C-reactive protein, interleukin-6 and tumor necrosis factor alpha as predictors of incident coronary and cardiovascular events and total mortality A population-based, prospective study. Thromb Haemost 2006;95:511-518.
43. Nicholls SJ, Hazen SL. Myeloperoxidase and cardiovascular disease. Arterioscler Thromb Vasc Biol 2005;25:1102-1111.
44. Gonzalez-Quesada C, Frangogiannis NG. Monocyte chemoattractant protein-1/CCL2 as a biomarker in acute coronary syndromes. Curr Atheroscler Rep 2009;11:131-138.
45. Newby AC. Metalloproteinase expression in monocytes and macrophages and its relationship to atherosclerotic plaque instability. Arterioscler Thromb Vasc Biol 2008;28:2108-2114.
46. Lehrke M, Greif M, Broedl UC, et al. MMP-1 serum levels predict coronary atherosclerosis in humans. Cardiovasc Diabetol 2009;8:50.
47. Miller VM, Redfield MM, McConnell JP. Use of BNP and CRP as biomarkers in assessing cardiovascular disease: Diagnosis versus risk. Curr Vasc Pharmacol 2007;5:15-25.
48. Bar-Or D, Winkler JV, Vanbenthuysen K, Harris L, Lau E, Hetzel FW. Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: A preliminary comparison to creatine kinase-MB, myoglobin, and troponin I. Am Heart J 2001;141:985-991.
49. Sbarouni E, Georgiadou P, Kremastinos DT, Voudris V. Ischemia modified albumin: Is this marker of ischemia ready for prime time use? Hellenic J Cardiol 2008;49:260-266.
50. Kleinfeld AM, Kleinfeld KJ, Adams JE III. Serum levels of unbound free fatty acids reveal high sensitivity for early detection of acute myocardial infarction in patient samples from the TIMI II trial. J Am Coll Cardiol 2002;39:312.
51. Azzazy HME, Pelsers MMAL, Christenson RH. Unbound free fatty acids and heart-type fatty acid-binding protein: Diagnostic assays and clinical applications. Clin Chem 2006;52:19-29.
52. Spiel AO, Gilbert JC, Jilma B. Von Willebrand factor in cardiovascular disease: Focus on acute coronary syndromes. Circulation 2008;117:1449-1459.
53. Danesh J, Whincup P, Walker M, et al. Fibrin D-dimer and coronary heart disease: Prospective study and meta-analysis. Circulation 2001;103:2323-2327.
54. The Emerging Risk Factors Collaboration. C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 2012;367:1310-1320.
55. Raiko JRH, Oikonen M, Wendelin-Saarenhovi M, et al. Plasminogen activator inhitor-1 associates with cardiovascular risk factors in healthy young adults in the Cardiovascular Risk in Young Finns Study. Atherosclerosis 2012;224:208-212.
56. André P, Nannizzi-Alaimo L, Prasad SK, Phillips DR. Platelet-derived CD40L: The switch-hitting player of cardiovascular disease. Circulation 2002;106:896-899.
57. Wang Y, Li L, Tan H-W, Yu G-S, Ma Z-Y, Zhao YX, Zhang Y. Transcoronary concentration gradient of sCD40L and hsCRP in patients with coronary heart disease. Clin Cardiol 2007;30:86-91.
58. Kones R. Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease-a perspective. Drug Des Devel Ther 2010;9:383-413.
59. Lloyd-Jones DM, Liu K, Tian L, Greenland P. Narrative review: Assessment of C-reactive protein in risk prediction for cardiovascular disease. Ann Intern Med 2006;145:35-42.
60. Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol 2010;106:56-61.
61. Di Angelantonio E, Chowdhury R, Sarwar N, et al. B-type natriuretic peptides and cardiovascular risk: Systematic review and meta-analysis of 40 prospective studies. Circulation 2009;120:2177-2187.
62. Redfield MM, Rodeheffer RJ, Jacobsen SJ, Mahoney DW, Bailey KR, Burnett JC Jr. Plasma brain natriuretic peptide concentration: Impact of age and gender. J Am Coll Cardiol 2002;40:976-982.
63. Dao Q, Krishnaswamy P, Kazanegra R, et al. Utility of B-type natriuretic peptide in the diagnosis of congestive heart failure in an urgent-care setting. J Am Coll Cardiol 2001;37:379-385.
64. Munagala VK, Burnett JC Jr, Redfield MM. The natriuretic peptides in cardiovascular medicine. Curr Probl Cardiol 2004;29:707-769.
65. Porapakkham P, Porapakkham P, Zimmet H, Billah B, Krum H. B-type natriuretic peptide-guided heart failure therapy: A meta-analysis. Arch Intern Med 2010;170:507-514.
66. Scott PA, Barry J, Roberts PR, Morgan JM. Brain natriuretic peptide for the prediction of sudden cardiac death and ventricular arrhythmias: A meta-analysis. Eur J Heart Fail 2009;11:958-966.
67. Ryding AD, Kumar S, Worthington AM, Burgess D. Prognostic value of brain natriuretic peptide in noncardiac surgery: A meta-analysis. Anesthesiology 2009;111:311-319.
68. Thygesen K, Alpert JS, White HD, et al. Universal definition of myocardial infarction: Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Eur Heart J 2007;28:2525-2538.
69. Rubini Gimenez M, Hoeller R, Reichlin T, et al. Rapid rule out of acute myocardial infarction using undetectable levels of high-sensitivity cardiac troponin. Int J Cardiol 2013;168:3896-3901.
70. Kociol RD, Pang PS, Gheorghiade M, Fonarow GC, O'Connor CM, Felker GM. Troponin elevation in heart failure: Prevalence, mechanisms, and clinical implications. J Am Coll Cardiol 2010;56:1071-1078.
71. Januzzi JL, Filippatos G, Nieminen M, Gheorghiade M. Troponin elevation in patients with heart failure: On behalf of the third Universal Definition of Myocardial Infarction Global Task Force: Heart Failure Section. Eur Heart J 2012;33:2265-2271.
72. Folsom AR. Classical and Novel biomarkers for cardiovascular risk prediction in the United States. J Epidemiol 2013;23:158-162.
73. Schunkert H, Konig IR, Kathiresan S, et al. Large-scale association analysis identifies 13 new susceptibility loci for coronary artery disease. Nat Genet 2011;43:333-338.
74. O'Donnell CJ, Nabel EG. Genomics of cardiovascular disease. N Engl J Med 2011;365:2098-2109.
75. Polonsky TS, McClelland RL, Jorgensen NW, et al. Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 2010;303:1610-1616.
76. Stein JH, Tattersall MC. Carotid intima-media thickness and cardiovascular disease risk prediction. J Am Coll Cardiol 2014;63:2301-2302.
77. Den Ruijter HM, Peters SE, Anderson TJ, et al. Common carotid intima-media thickness measurements in cardiovascular risk prediction: A meta-analysis. JAMA 2012;308:796-803.
78. Lin JS, Olson CM, Johnson ES, Whitlock EP. The ankle-brachial index for peripheral artery disease screening and cardiovascular disease prediction among asymptomatic adults: A systematic evidence review for the U.S. preventive services task force. Ann Intern Med 2013;159:333-341.
79. Hlatky MA, Greenland P, Arnett DK, et al., American Heart Association Expert Panel on Subclinical Atherosclerotic Diseases and Emerging Risk Factors and the Stroke Council. Criteria for Evaluation of Novel Markers of Cardiovascular Risk: A Scientific Statement From the American Heart Association. Circulation 2009;119:2408-2416.
80. Moons KGM. Criteria for scientific evaluation of novel markers: A perspective. Clin Chem 2010;56:537-541.
81. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004;364:937-952.
82. Capewell S, Graham H. Will cardiovascular disease prevention widen health inequalities? PLoS Med 2010;7:e1000320.
83. Kreatsoulas C, Anand SS. The impact of social determinants on cardiovascular disease. Can J Cardiol 2010;26(Suppl C):8c-13c.
84. Rosengren A, Hawken S, Ounpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): Case-control study. Lancet 2004;364:953-962.
85. Chandola T, Britton A, Brunner E, et al. Work stress and coronary heart disease: What are the mechanisms? Eur Heart J 2008;29:640-648.
86. Kivimaki M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary heart disease: A collaborative meta-analysis of individual participant data. Lancet 2012;380:1491-1497.
87. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: A meta-analytic review. PLoS Med 2010;7:e1000316.
88. Knox SS, Uvnäs-Moberg K. Social isolation and cardiovascular disease: An atherosclerotic pathway? Psychoneuroendocrinology 1998;23:877-890.
89. Roux AVD, Merkin SS, Arnett D, et al. Neighborhood of residence and incidence of coronary heart disease. N Engl J Med 2001;345:99-106.
90. Barker D, Eriksson J, Forsén T, Osmond C. Fetal origins of adult disease: Strength of effects and biological basis. Int J Epidemiol 2002;31:1235-1239.
91. Lang T, Lepage B, Schieber AC, Lamy S, Kelly-Irving M. Social determinants of cardiovascular diseases. Public Health Rev 2012;33:601-622.
92. Rose G. The strategy of preventive medicine. Oxford: Oxford University Press, 1992.
93. Pell JP, Haw S, Cobbe S, et al. Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med 2008;359:482-491.
94. Jooste PL, Weight MJ, Lombard CJ. Short-term effectiveness of mandatory iodization of table salt, at an elevated iodine concentration, on the iodine and goiter status of schoolchildren with endemic goiter. Am J Clin Nutr 2000;71:75-80.
95. Manuel DG, Lim J, Tanuseputro P, Anderson GM, Alter DA, Laupacis A, Mustard CA. Revisiting Rose: Strategies for reducing coronary heart disease. BMJ 2006;332:659-662.
96. Stevens RJ, Kothari V, Adler AI, Stratton IM. The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). Clin Sci 2001;101:671-679.
97. Donnan PT, Donnelly L, New JP, Morris AD. Derivation and validation of a prediction score for major coronary heart disease events in a U.K. type 2 diabetic population. Diabetes Care 2006;29:1231-1236.
98. Chamnan P, Simmons RK, Sharp SJ, Griffin SJ, Wareham NJ. Cardiovascular risk assessment scores for people with diabetes: a systematic review. Diabetologia 2009;52:2001-2014.
99. Yang X, So W-Y, Kong APS, et al. Development and validation of a total coronary heart disease risk score in type 2 diabetes mellitus. Am J Cardiol 2008;101:596-601.
100. Simmons RK, Coleman RL, Price HC, Holman RR, Khaw K-T, Wareham NJ, Griffin SJ. Performance of the UK prospective diabetes study risk engine and the Framingham risk equations in estimating cardiovascular disease in the EPIC-Norfolk cohort. Diabetes Care 2009;32:708-713.
101. Shulman NB, Ford CE, Hall WD, Blaufox MD, Simon D, Langford HG, Schneider KA. Prognostic value of serum creatinine and effect of treatment of hypertension on renal function. Results from the hypertension detection and follow-up program. The Hypertension Detection and Follow-up Program Cooperative Group. Hypertension 1989;5(Suppl):I80-I93.
102. Sarnak MJ, Levey AS, Schoolwerth AC, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension 2003;42:1050-1065.
103. Levey AS, Beto JA, Coronado BE, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am J Kidney Dis 1998;32:853-906.
104. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, Brindle P. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 2008;336:1475-1482.
105. Kitas GD, Erb N. Tackling ischaemic heart disease in rheumatoid arthritis. Rheumatology 2003;42:607-613.
106. Sandoo A, van Zanten JJ, Metsios GS, Carroll D, Kitas GD. The endothelium and its role in regulating vascular tone. Open Cardiovasc Med J 2010;4:302-312.
107. Sandoo A, Veldhuijzen van Zanten JJ, Metsios GS, Carroll D, Kitas GD. Vascular function and morphology in rheumatoid arthritis: a systematic review. Rheumatology (Oxford, England) 2011;50:2125-2139.
108. Kitas GD, Gabriel SE. Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 2011;70:8-14.
109. Sandoo A, Chanchlani N, Hodson J, Smith JP, Douglas KM, Kitas GD. The relationship between cardiovascular disease risk prediction scores and vascular function and morphology in rheumatoid arthritis. Clin Exp Rheumatol 2014;32:914-921.
110. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983;67:968-977.
111. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009;53:1925-1932.
112. Hainer V, Aldhoon-Hainerová I. Obesity paradox does exist. Diabetes Care 2013;36(Suppl 2):S276-S281.
113. Goh LGH, Dhaliwal SS, Welborn TA, Lee AH, Della PR. Ethnicity and the association between anthropometric indices of obesity and cardiovascular risk in women: a cross-sectional study. BMJ Open 2014;4:e004702.