Making a case for quantitative assessment of cardiovascular risk

Cardiovascular disease (CVD) causes nearly one third of all deaths worldwide. Estimates of the cumulative effects of the most common cardiovascular risk factors indicate that >30% of the chronic care burden of CVD and >50% of deaths from CVD are attributable to modifiable risk factors, such as cigarette smoking, elevated low-density lipoprotein cholesterol, low levels of high-density lipoprotein cholesterol, diabetes mellitus, and hypertension. While a significant percentage of patients present with one or more of these risk factors, health care practitioners encounter great difficulty in achieving long-term patient adherence to risk-factor modification interventions. More accurate stratification of death and disability risk across age, gender, and ethnic categories-and more comprehensible quantification of the magnitude and timeframe of the impact of risk-factor modification on such risks-will likely be useful to patients and health care practitioners in the implementation of more effective strategies. There is a need to study which risk-assessment methodologies, which depictions of short- and long-term risk, and which intervention modalities will have the greatest possible impact on patients' understanding of risk factors and risk-modification behaviors.