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Old and new cardiovascular risk factors: from unresolved issues to new opportunities

Renke Maas1, Rainer H Böger

  • 1Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. maas@uke.uni-hamburg.de

Atherosclerosis. Supplements
|December 11, 2003
PubMed

Insights

Cardiovascular risk assessment faces challenges due to combined endpoints and inaccurate event verification. Distinguishing between statin-sensitive and statin-insensitive risks may refine future cardiovascular disease prediction.

Area of Science:

  • Cardiovascular Research
  • Risk Assessment
  • Epidemiology

Background:

  • Current cardiovascular risk assessment practices combine diverse vascular events and employ potentially inaccurate verification methods.
  • Overlapping pathophysiological pathways of traditional risk factors (hypertension, obesity, diabetes) complicate accurate risk evaluation.
  • Establishing causality for cardiovascular disease is challenging, exemplified by LDL cholesterol modification and statin pleiotropic effects.

Purpose of the Study:

  • To identify controversial issues in cardiovascular research and risk assessment.
  • To discuss unresolved issues concerning established and emerging cardiovascular risk factors.
  • To propose alternative frameworks for understanding cardiovascular risk, such as statin-sensitive and statin-insensitive risk.

Main Methods:

  • Review of general aspects of risk factor evaluation.
  • Discussion of unresolved issues in established and emerging risk factors.
  • Evaluation of future prospects for novel risk factors including CRP, homocysteine, ADMA, oxLDL, and isoprostanes.

Main Results:

  • Inaccurate verification of vascular events and imprecise definitions of cardiovascular risk blur current estimates.
  • Overlapping properties of traditional risk factors present challenges in risk assessment.
  • The review highlights the need to consider statin-sensitive and statin-insensitive cardiovascular risk.

Conclusions:

  • Ambiguous terminology and varying definitions of cardiovascular risk contribute to controversial issues.
  • Emerging risk factors and evolving lifestyle/treatment patterns necessitate a re-evaluation of the risk factor hierarchy.
  • Future cardiovascular risk assessment may require a more nuanced approach beyond traditional metrics.

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