[Cardiovascular prevention: current progress and the long road to travel]

This article describes the limitations of the currently available screening modalities used for determining cardiovascular risk in the general population. In addition, it contains an analysis of the potential ways in which the predictive and classificatory abilities of the cardiovascular risk charts used in primary care can be improved to enable them to function more effectively. Also included are discussions of existing opportunities for improving current strategies for screening and cardiovascular prevention, of the value of measuring new biomarkers in individual patients, including genetic predisposition to coronary heart disease, and of some of the clinical measures used in practice, such as the ankle-brachial index and the carotid intima-media thickness. In addition, the most important subgroups of individuals at a high cardiovascular risk, as judged by their size and the number of cardiovascular events experienced at 10 years, are described. Finally, there is a brief review of the potential role that image modalities currently being developed could play in particular subgroups of asymptomatic individuals with an elevated disease risk.