General and individual risk scales

General and individual risk scales

Due to the fact that many predictors of risk correlate with each other, risk can often be predicted based on information about several risk factors (RF). In most cases, many risk factors (RF) can be identified during initial screening, but it is sufficient to identify several easily measurable risk factors (RF) to calculate the overall risk for coronary heart disease (CHD).

For those who, at the initial screening, the risk is very low or very high, the measurement and evaluation of additional risk factors will give very little useful information, i.e. additional screening will add valuable information only in patients with intermediate risk. Evaluating individual absolute risk will allow you to select cost-effective intervention.

As evidence of the importance of assessing individual risk, NCEP, ATP III, JNC-7, and USPSTF suggested several options for assessing individual risk to determine the intensity of various interventions. The American Diabetes Association also recommends an absolute risk based treatment approach.

Usually, the presence or absence of cardiovascular disease (CVD) is sufficient for the distribution of patients with high or low risk. Patients with established CVD, such as damage to the coronary artery, cerebrovascular or peripheral arteries, constitute the first high-risk group. They always have a higher average risk than those without CVD. Approximately 80% of patients with established CVD will die from this disease, while among those without an established CVD, the death rate will be only 50% of the mortality rates from CVD.

As discussed later in this chapter, people with CVD usually need more “aggressive” interventions. Reducing the risk in these patients refers to secondary prevention, and among those without obvious CVD to the primary.

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