Primary prevention for patients with intermediate Framingham risk scores

Coronary heart disease (CHD) is the leading cause of mortality in the industrialized world. Proper identification of individuals at risk for CHD is challenging. The Framingham Risk Score, the most widely accepted tool for quantifying 10-year risk, fails to identify a great proportion of future CHD. Because of the health and economic consequences of CHD, there is a need to develop better prognostic tools for primary prevention. Coronary artery calcium scoring, C-reactive protein measurement, and heart rate recovery and exercise tolerance during exercise stress test may be useful tools for better risk stratification of intermediate-risk patients.