Cardiovascular Risk Factors: It's Time to Focus on Variability!

Area of Science:

• Cardiovascular Medicine
• Preventive Cardiology
• Metabolic Syndrome

Background:

• Atherosclerotic heart disease is a major global health burden.
• Managing cardiovascular risk factors like blood pressure, lipids, glucose, and weight is crucial but doesn't eliminate residual risk.
• Intraindividual variability in risk factor control is an emerging area of concern.

Purpose of the Study:

• To highlight the potential contribution of intraindividual risk factor variability to residual cardiovascular risk.
• To propose a shift in risk factor assessment beyond magnitude and duration to include variability over time.

Main Methods:

• Review of emerging data on cardiovascular risk factor variability.
• Analysis of traditional risk factor management strategies.
• Conceptual framework for incorporating risk factor variability into risk assessment.

Main Results:

• Residual risk persists despite adherence to evidence-based risk factor targets.
• Intraindividual variability in blood pressure, lipid, glucose, and body weight levels is increasingly recognized as a contributor to cardiovascular events.
• Traditional risk assessment may underestimate risk by not accounting for factor fluctuations.

Conclusions:

• Assessing cardiovascular risk solely by the average level and duration of risk factors may be insufficient.
• Incorporating the concept of intraindividual risk factor variability into clinical practice could refine risk prediction and management strategies.
• Future research should focus on quantifying and integrating risk factor variability into cardiovascular risk models.