Cardiovascular risk assessment - From individual risk prediction to estimation of global risk and change in risk in the population

John A Batsis,Francisco Lopez-Jimenez

doi:10.1186/1741-7015-8-29

John A Batsis, Francisco Lopez-Jimenez

Open Access

https://doi.org/10.1186/1741-7015-8-29

Copy DOI

Abstract

BackgroundCardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions.DiscussionUsing cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk using easily obtainable clinical variables. Because of conflicting data estimates of the incidence and prevalence of cardiovascular disease, risk prediction formulae may be a useful tool to estimate such risk at a population level.SummaryAlthough risk prediction formulae were intended on guiding clinicians to individualized therapy, they also can be used to ascertain trends at a population-level, particularly in situations where changes in different cardiovascular risk factors over time have different magnitudes and directions. The efficacy of interventions that are proposed to reduce cardiovascular risk impacting more than one risk factor can be well assessed by these means.

Highlights

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to identify patients at high risk that may require therapeutic interventions
Summary: risk prediction formulae were intended on guiding clinicians to individualized therapy, they can be used to ascertain trends at a population-level, in situations where changes in different cardiovascular risk factors over time have different magnitudes and directions
CV risk prediction formulae and tables are decision tools that allow the identification of patients at high risk of CV disease

Summary

Discussion

Limitations of studies assessing the prevalence of coronary artery disease The assessment of disease burden in the population is of critical importance for public health officials and health care policy makers. In the study by Adams et al [49], the adjusted long-term mortality was 40% lower in the surgical group with 7.1 years of follow-up These results suggest that prediction tools like the FRS can potentially be practically used to estimate actual number of events in patients at higher cardiometabolic risk. Other interventions, such as sodium restriction have larger effects on CV disease than its impact on blood pressure alone and modest effects yield greater than expected changes, which extend beyond such clinical markers [51] This may limit the use of such prediction rules in forecasting trends in CV events using information related to changes in CV risk factors.

Background

Findings

Agency for Healthcare Quality Research