Cardiovascular Risk Assessment and Lipid-Lowering Therapy Recommendations in Primary Prevention

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Cardiovascular disease (CVD) is a leading global cause of death, necessitating robust primary prevention strategies.
• Current CVD risk assessment tools like SCORE2, PCEs, and PREVENT guide primary prevention but exhibit performance variations.
• Statin therapy is a cornerstone of CVD prevention, recommended for individuals exceeding specific risk thresholds.

Purpose of the Study:

• To review current cardiovascular disease (CVD) risk assessment tools and lipid-lowering recommendations.
• To highlight the impact of risk modifiers and asymptomatic atherosclerosis detection on individualized primary prevention.
• To address inconsistencies in statin therapy practices and identify factors contributing to inadequate dyslipidemia control.

Main Methods:

• Narrative review of existing scientific literature.
• Examination of current cardiovascular disease (CVD) risk assessment methodologies (SCORE2, PCEs, PREVENT).
• Analysis of lipid-lowering recommendations and the role of asymptomatic atherosclerosis screening.

Main Results:

• Discrepancies exist in the performance of CVD risk assessment tools and recommended intervention thresholds.
• Physician inertia and poor patient adherence hinder effective dyslipidemia management.
• Asymptomatic atherosclerosis detection aids in reclassifying risk and tailoring primary prevention strategies.

Conclusions:

• Standardized CVD risk assessment and consistent application of lipid-lowering guidelines are needed.
• Targeted screening for asymptomatic atherosclerosis can enhance individualized primary prevention.
• Addressing barriers to statin therapy and improving adherence are critical for reducing CVD burden.