Researchers defined CVD as coronary heart disease, stroke, peripheral vascular disease, or heart failure. They stated that although risk factors for these conditions vary, there is sufficient overlap and interaction to warrant the creation of a global assessment tool. Furthermore, the use of existing, proven risk evaluation algorithms has declined in primary care offices.

At baseline, 8,491 CVD-free participants with a mean age of 49 years (consisting of 4,522 women) were evaluated on blood pressure, serum total and HDL cholesterol, smoking status, diabetes or use of insulin and related medications, and use of antihypertensive medication. Blood pressure and cholesterol levels were comparable between men and women, but diabetes was more prevalent in men and mean serum HDL levels were higher in women. A sex-specific Cox proportional-hazards regression was used to relate risk factors to incidence of a first CVD event during a maximum follow-up period of 12 years. Results indicated that use of the new model was statistically significantly better than older models for both men and women in predicting CVD.

The authors conclude that more research is needed to validate the new assessment tool, given the predominantly white Framingham sample and the existence of other CVD risk factors that were not included in the current model. They do say, however, that the algorithm presents an easy-to-use and convenient tool for the primary care setting. One of the reasons it is so applicable is that a preventive measure taken to ward off any one CVD event will likely also prevent others. And because CVD is largely preventable, using risk assessment data is an important endeavor.

As Michael R. Jaff, DO, Vascular Medicine Specialist and Medical Director of the Massachusetts General Hospital Vascular Diagnostic Laboratory, says: "The ability to accurately predict cardiovascular risk is critical for physicians in practice today. Many 'scoring systems' have been cumbersome and difficult to utilize. This current model utilizes simple, well-described risk factors, but provides a point system that correlates to 'vascular health.' Although a study looking at the validation of this model is critical, it is a promising and hopeful tool that will allow us to appropriately stratify our high-risk population of patients."

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Source: D'Agostino RB, Sr, Vasan RS, Pencina MJ, et al. 2008. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Published January 22, 2008 on the Circulation website.

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