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Risk estimation for the primary prevention of cardiovascular disease: considerations for appropriate risk prediction

Kim Robin van Daalen1, Dudan Zhang1, Stephen Kaptoge1

  • 1British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.

The Lancet. Global Health
|July 19, 2024
PubMed

Insights

Cardiovascular disease risk scores help prevent heart disease deaths. This review guides selecting the best score for your population to ensure accurate risk assessment and informed clinical decisions.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Health Services Research

Background:

  • Cardiovascular diseases (CVDs) are the leading global cause of mortality.
  • Cardiovascular disease risk scores are crucial for primary prevention, identifying high-risk individuals for interventions.
  • Existing risk scores vary significantly due to differing data sources and populations, potentially leading to inaccurate risk assignments.

Purpose of the Study:

  • To provide an updated overview of guideline-recommended cardiovascular disease risk scores.
  • To evaluate and compare the characteristics and qualities of various risk scores.
  • To offer guidance on selecting the most appropriate risk score for specific target populations.

Main Methods:

  • Systematic review of guideline-recommended cardiovascular disease risk scores.
  • Comparative analysis of risk score derivation data, population applicability, and assigned risk values.
  • Evaluation of global, regional, and national risk scoring tools.

Main Results:

  • Significant heterogeneity exists among cardiovascular disease risk scores in terms of data sources and risk prediction accuracy.
  • Mismatches between derivation and target populations can lead to risk over/underestimation and suboptimal clinical decisions.
  • A wide array of risk scores necessitates careful selection based on population-specific epidemiology.

Conclusions:

  • Accurate cardiovascular disease risk assessment is vital for effective primary prevention.
  • Selection of an appropriate risk score requires careful consideration of its origin and applicability to the target population.
  • This review aims to facilitate informed choices among available cardiovascular disease risk scores to improve patient outcomes.

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