Short-term versus lifetime risk assessment for cardiovascular disease: Pros, cons, and clinical implications

Abstract

Atherosclerotic disease develops over decades, thus preceding end-organ events, myocardial infarction, and stroke by many years. Identifying risk factors for atherosclerotic disease development is necessary to guide early primary prevention measures. The most widely accepted risk estimation tools, 10-year risk profiles, may not adequately predict true future burden of cardiovascular disease. Lifetime risk assessment estimates the chance of developing a given disease before death and may be an important adjunct to short-term risk estimation. Therefore, recent efforts to estimate lifetime risk have been developed to better characterize the long-term burden of cardiovascular disease, compare absolute risks between common diseases, and guide preventive treatment decisions for younger patients with cardiovascular risk factors. In this article, we discuss techniques of short-term (10-year) and lifetime risk calculation and the benefits, limitations, and clinical implications of both techniques of risk assessment.