Cardiovascular risk estimation at the individual level

ESC CardioMed ◽  
2018 ◽  
pp. 846-863
Author(s):  
Yvo M. Smulders ◽  
Marie-Therese Cooney ◽  
Ian Graham
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Estimation ◽  
Pharmacological Therapy ◽  
Cardiovascular Risks ◽  
Individual Level ◽  
The Individual ◽  
Very High ◽  
Cardiovascular Risk Estimation

The absolute benefit of any measure to prevent cardiovascular disease, be it lifestyle improvement or pharmacological therapy, depends on the baseline cardiovascular risk. This risk cannot be assessed exactly, but only be estimated because many known risk determinants cannot be accounted for in existing risk scoring systems, and because the application to an individual of risk estimates derived from populations is imprecise. Several cardiovascular risk estimation methods are available, and the European Society of Cardiology has favoured the European-based Systematic COronary Risk Evaluation (SCORE) system as a basis for their cardiovascular disease prevention guidelines. SCORE estimates absolute 10-year cardiovascular mortality risk. In specific circumstances, estimation of relative risk, risk age, or lifetime risk may be considered. High- and very-high-risk population are defined by SCORE risks greater than 5% and greater than 10%, respectively, or by clinical conditions conferring (very) high risk, such as existing cardiovascular disease or chronic kidney disease. The role of additional risk information on top of the information entered in SCORE is generally limited. In particular, markers of early cardiovascular damage should be collected and interpreted with caution. Absolute cardiovascular risks in young and elderly individuals are almost always low or very high, respectively, and the options for appropriate interpretation and management of these risks are discussed.

Cardiovascular risk estimation at the individual level

ESC CardioMed ◽  
2018 ◽  
pp. 846-863
Author(s):  
Yvo M. Smulders ◽  
Marie-Therese Cooney ◽  
Ian Graham
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Estimation ◽  
Pharmacological Therapy ◽  
Cardiovascular Risks ◽  
Individual Level ◽  
The Individual ◽  
Very High ◽  
Cardiovascular Risk Estimation

The absolute benefit of any measure to prevent cardiovascular disease, be it lifestyle improvement or pharmacological therapy, depends on the baseline cardiovascular risk. This risk cannot be assessed exactly, but only be estimated because many known risk determinants cannot be accounted for in existing risk scoring systems, and because the occurrence of cardiovascular disease is likely to depend not just on pre-existing risk factors, but also on chance. Several cardiovascular risk estimation methods are available, and the European Society of Cardiology has favoured the European-based Systematic COronary Risk Evaluation (SCORE) system as a basis for their cardiovascular disease prevention guidelines. SCORE estimates absolute 10-year cardiovascular mortality risk. In specific circumstances, estimation of relative risk, risk age, or lifetime risk may be considered. High- and very-high-risk population are defined by SCORE risks greater than 5% and greater than 10%, respectively, or by clinical conditions conferring high risk, such as existing cardiovascular disease or chronic kidney disease. The role of additional risk information on top of the information entered in SCORE is generally limited. In particular, markers of early cardiovascular damage should be collected and interpreted with caution. Absolute cardiovascular risks in young and elderly individuals are almost always low or very high, respectively, and the options for appropriate interpretation of these risks are discussed.

scholarly journals HYPERTENSION OFFICE: OPPORTUNITIES AND PROSPECTS FOR PRIMARY HEALTH CARE

2013 ◽  
Vol 19 (6) ◽  
pp. 545-550
Author(s):  
N. A. Paskar
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Moderate Risk ◽  
Primary Health ◽  
Special Software ◽  
Integral Estimation ◽  
Design And Methods ◽  
Very High

Objective. To analyze the work of the Hypertension office to explore the risk factors of cardiovascular disease and prevention opportunities.Design and methods. The study included 2049 subjects (1549 women and 500 men) surveyed in 10 Hypertension offices. The special software «Cardiometer-MТ» JSC «MICARD-LANA» (Russia) was used for the automated integral estimation of the functional state of the cardiovascular system.Results. The fatal cardiovascular risk by the SCORE scale was estimated: very high risk was observed in 33,7 % cases, high risk — in 31,1 %, moderate risk — in 12,4 %, low risk — in 19,7 % cases. Conclusions. The methods applied in this work contribute to the development of the database and to the primary prevention in people with cardiovascular risk factors.

scholarly journals Established and Emerging Approaches for the Management of Dyslipidaemia

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Giuseppe Danilo Norata
Keyword(s):  
Experimental Data ◽  
Cardiovascular Disease ◽  
Clinical Trials ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Ldl Cholesterol ◽  
Reasonable Doubt ◽  
Risk Patients ◽  
Very High

The key role of dyslipidaemia in determining cardiovascular disease (CVD) has been proved beyond reasonable doubt, and therefore several dietary and pharmacological approaches have been developed. The discovery of statins has provided a very effective approach in reducing cardiovascular risk as documented by the results obtained in clinical trials and in clinical practice. The current efficacy of statins or other drugs, however, comes short of providing the benefit that could derive from a further reduction of LDL cholesterol (LDL-C) in high-risk and very high risk patients. Furthermore, experimental data clearly suggest that other lipoprotein classes beyond LDL play important roles in determining cardiovascular risk. For these reasons a number of new potential drugs are under development in this area. Aim of this review is to discuss the available and the future pharmacological strategies for the management of dyslipidemia.

scholarly journals Application of Total Cardiovascular Risk Estimation in The Management of A Patient with Cardiovascular Risk

2012 ◽  
Vol 7 (1) ◽  
pp. 28-34
Author(s):  
Manzoor Mahmood ◽  
MA Muqueet ◽  
Md Harisul Hoque ◽  
SM Mustafa Zaman ◽  
Md Muklesur Rahman ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Estimation ◽  
Medical Intervention ◽  
British Society ◽  
Coronary Risk ◽  
Heart Score ◽  
Life Style Changes ◽  
History Of ◽  
Cardiovascular Risk Estimation

Medical intervention based on the concept of total coronary risk in the asymptomatic population without cardiovascular disease (CVD) is widely advocated throughout the world.All adults above 40 years, without history of CVD or diabetes, and who are not on treatment for blood pressure (BP) or lipids, should be considered for a comprehensive risk assessment in primary care once every five years. Our patient is an asymptomatic obese, hypertensive, dyslipidaemic individual who is also a smoker. He has a family history of premature atherosclerotic disease. His co-morbidities include mild asthma and hepatic impairment. His estimated total cardiovascular risk according to Joint British Society risk score1 for 10 year cardiovascular event is 40% which qualifies him in the high risk category.His estimated score according to HEART score based on the SCORE project2 is 7% which refers to a 10-year risk mortality. According to HEARTSCORE, a score of more than 5 is considered to be at high risk. The following discussion aims to cut down his cardiovascular risk by having life-style changes and use of cardioprotective medication where appropriate. DOI: http://dx.doi.org/10.3329/uhj.v7i1.10207 UHJ 2011; 7(1): 28-34

scholarly journals Estimation of the 10-Year Risk of Fatal Cardiovascular Disease in the Portuguese Population: Results from the First Portuguese Health Examination Survey (INSEF 2015)

2020 ◽  
Vol 33 (11) ◽  
pp. 726
Author(s):  
Vânia Gaio ◽  
Ana Paula Rodrigues ◽  
Irina Kislaya ◽  
Marta Barreto ◽  
Sónia Namorado ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
European Countries ◽  
Occupational Activity ◽  
Health Examination ◽  
High Cardiovascular Risk ◽  
Portuguese Population ◽  
Health Examination Survey ◽  
Very High

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in Portugal and globally. Cardiovascular risk algorithms, namely the SCORE (Systematic Coronary Risk Evaluation), are recommended in the context of cardiovascular disease prevention. Our aim is to estimate and characterize the cardiovascular risk of the Portuguese population aged between 40 and 65 years old, in 2015, using the SCORE algorithm.Material and Methods: This study was performed on a subsample of the first Portuguese National Health Examination Survey - INSEF, including all participants between 40 and 65 years old with available data on sex, age, smoking status, total cholesterol and systolic blood pressure (n = 2945). The prevalence of the cardiovascular risk categories were stratified by sex, age group, marital status, educational level, occupational activity, urbanization of living area, region and income.Results: In 2015, about 5.1% and 11.9% of the Portuguese resident population aged between 40 and 65 years old were, respectively, at high and very high risk of having a fatal CV event in the following 10 years. The highest prevalence of very high cardiovascular risk was found in males, individuals aged 60-65 years old, married or living with someone, without any formal education or just with the 1st cycle of basic education and belonging to the less skilled category of the occupational activity (C category) in comparison with the othercorresponding groups.Discussion: A previous national study found a similar proportion of the population at high/very high cardiovascular risk (19.5% versus 17.1%). Our study is representative of the adult Portuguese population and adopted the European Health Examination Survey procedures, which are essential for future comparisons with other European countries. Some of the limitations of this study include the possible participation bias and the non-calibration of the SCORE algorithm for the Portuguese population.Conclusion: In 2015, a considerable proportion of the Portuguese population aged between 40 and 65 years old had a high or very high risk of developing a fatal cardiovascular event in the next 10 years. Due to the possible overestimation of the cardiovascular risk already reported in other European countries, it will be important to carry out a follow-up study to validate the adequacy of using the SCORE algorithm in the Portuguese population.

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