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How to assess cardiovascular risk? Volume 4, issue 4, Juillet-Août 2008

Author
Pole cardiovasculaire et métabolique, CHU de Toulouse

Global cardiovascular risk (CVR) is estimated either by summing the main CVR factors (hypertension, dyslipidaemia and diabetes), each factor being considered as either present or absent and having an identical weighting or by using a risk model (statistical modelling) which uses the true value of each CVR factor.Two risk models (Framingham and SCORE) have been validated. They classify patients by risk level and predict risk of a cardiovascular event in 5 or 10 years’time. Their performance has not been assessed in a French population representative of the general population. The Framingham models, derived from North American cohorts, overestimate global CVR and adjustment (or recalibration) is required. The SCORE models, derived from European cohorts, estimate only the risk of death from coronary or non-coronary cardiovascular disease, and propose two statistical models, one for low, the other for high prevalence of cardiovascular diseaseGuidelines on CVR factors (hypertension, dyslipidaemia and diabetes) need to be standardized in terms of method used to estimate global CVR (recalibrated Framingham and/or SCORE) and management strategy for individuals with several CVR factors.