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Canadian Journal of Cardiology

Gambling With Cardiovascular Disease Risk Models: How to Choose and How to Use

Published:February 25, 2021DOI:https://doi.org/10.1016/j.cjca.2021.02.013

      Abstract

      Cardiovascular risk assessment has been shown to improve physicians’ and patients’ understanding of an individual’s future risk of cardiovascular disease (CVD). It has also been shown to improve the management of cardiovascular risk factors including hypertension and dyslipidemia. Given the challenges of engaging patients to adhere to healthy lifestyle habits or take medications for hypertension and dyslipidemia, the primary role of CVD risk assessment should be to open a discussion about the patient’s risk for CVD and associated conditions like adult-onset diabetes. Calculating a patient’s long-term risk and estimating the benefits of lifestyle changes or risk factor management may then be used to support long-term patient adherence. However, risk assessment is only a first step and must be followed by evidence-based health-promotion strategies and risk factor medications that have been proven to work.

      Résumé

      L’évaluation du risque de maladies cardiovasculaires (MCV) a permis aux médecins et aux patients de mieux comprendre le risque de survenue de MCV chez une personne donnée. Elle a aussi contribué à améliorer la prise en charge des facteurs de risque cardiovasculaires, dont l’hypertension et la dyslipidémie. Étant donné la difficulté d’amener les patients à adopter un mode de vie sain ou à prendre des médicaments contre l’hypertension et la dyslipidémie, l’évaluation du risque de MCV a pour principal objet d’engager un dialogue ouvert avec le patient afin que celui-ci sache quel est, dans son cas, le risque de MCV et d’autres maladies connexes comme le diabète de type 2. Le calcul du risque à long terme et l’estimation des bienfaits qu’apportent la modification du mode de vie ou la prise en charge des facteurs de risque peuvent ensuite servir à encourager l’observance thérapeutique à long terme. Toutefois, l’évaluation du risque n’est qu’une première étape qui doit être suivie par l’instauration de stratégies de promotion de la santé fondées sur des données probantes et de traitements médicamenteux qui se sont révélés efficaces pour réduire les facteurs de risque.
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