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Published on: September 26, 2018

Cardiovascular high-risk patients--treat to protect, but whom?

Faiez Zannad1, Anne Jakobsen, Jose Heroys

  • 1Hypertension and Heart Failure Unit, INSERM Clinical Investigation Centre, Nancy, France. f.zannad@chu-nancy.fr

Medscape Journal of Medicine
|May 9, 2008
PubMed

Insights

Assessing global cardiovascular risk is crucial for preventing coronary heart disease. The Systematic COronary Risk Evaluation (SCORE) project offers risk charts for European populations, improving risk assessment beyond the Framingham algorithm.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Public Health

Background:

  • Current coronary heart disease prevention guidelines stress global cardiovascular risk assessment.
  • The Framingham algorithm is a common tool but has limitations in European populations, especially low-risk ones.
  • Hypertension significantly increases coronary heart disease risk, often underestimated in clinical practice.

Purpose of the Study:

  • To evaluate cardiovascular risk stratification methods for coronary heart disease prevention.
  • To compare the applicability of the Framingham algorithm and the Systematic COronary Risk Evaluation (SCORE) project in European countries.
  • To highlight the importance of accurate risk assessment in hypertensive patients.

Main Methods:

  • Utilized the Framingham algorithm for cardiovascular risk stratification.
  • Employed the Systematic COronary Risk Evaluation (SCORE) risk charts for European populations.
  • Reviewed data on end-organ damage and additional biomarkers for prognostic information.
  • Analyzed results from major intervention trials on angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.

Main Results:

  • The Framingham algorithm is not universally applicable, particularly in low-risk European countries.
  • The SCORE project provides risk charts tailored for both low-risk and high-risk European countries.
  • Cardiovascular risk is frequently underestimated in clinical practice, especially in high-risk hypertensive patients.
  • Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers demonstrate significant cardiovascular event risk reduction across all risk levels.

Conclusions:

  • Accurate cardiovascular risk stratification is essential for effective coronary heart disease prevention.
  • The SCORE project offers a more geographically relevant tool for European populations compared to the Framingham algorithm.
  • Intervention with specific medications provides substantial benefits, particularly for high-risk individuals.

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