INSIGHTS INTO CARDIOVASCULAR RISK STRATIFICATION EVOLUTION AND CHALLENGES AHEAD
Main Article Content
Keywords
cardiovascular risk stratification, risk factors, Framingham Heart Study, risk assessment instruments, myocardial infarction, risk models, clinical practice
Abstract
Background: Throughout the history of public health and epidemiology, identifying elements that can explain or predict health disorders has been a persistent concern. In cardiovascular health, decades of work have led to the development of risk assessment instruments to identify individuals at significant risk and define appropriate therapeutic guidelines.
Objectives: This review aims to explore the fundamental components and principles of cardiovascular risk stratification, trace its evolution, and discuss current and future challenges in the field.
Methods: The review examines the concept of risk factors, first coined by Dr. Thomas R. Dawber of the Framingham Heart Study, as the basis for comprehensive cardiovascular risk management. It analyzes traditional risk factors, the development and adaptation of risk equations, and the importance of external validation and calibration for accurate risk estimation and management across different populations.
Results: Traditional risk factors account for a significant portion of myocardial infarction risk but vary between populations. The review highlights the necessity of suitable tools for accurate risk estimation and management and examines the challenges faced in the routine use of these tools in clinical practice.
Conclusion: Despite the existence of multiple risk models and guidelines, their routine use in clinical practice remains limited due to various challenges. Understanding the characteristics and limitations of risk models is crucial for enhancing their utility in cardiovascular risk prevention and management.
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Mandeep Kaur
Department Internal medicine, HCA Capital Regional Med Center 2626 Capital Medical Blvd, Tallahassee, FL 32308, USA
Dr. Priyadeep Kaur
MBBS, Punjab Institute of Medical Sciences, India
Chioma Ugochinyere Ozoalor
Medical Doctor, Department of Medicine, Worcestershire Royal Hospital, United Kingdom
Sri Pranita Cherukuri
MBBS, MPH, Columbia University, New York, United States
Dr. Avrina Kartika Ririe MD
Staff, Brain & Heart Center, Mohammad Hoesin General Hospital, Indonesia
Arike Badaru
MD, New Vision University, Tbilisi Georgia
Maudlyn O. Etekochay
MPH, MBA, Clinical QI Consultant, Inova Hospital, Department of Quality Improvement, USA