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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References
- The paradox of disease prevention: celebrated in principle, resisted in practice.JAMA. 2013; 310: 85-90
- Does the routine use of global coronary heart disease risk scores translate into clinical benefits or harms? A systematic review of the literature.BMC Health Serv Res. 2008; 8: 60
- Patient knowledge of coronary risk profile improves the effectiveness of dyslipidemia therapy: the CHECK-UP study: a randomized controlled trial.Arch Intern Med. 2007; 167: 2296-2303
- Do doctors accurately assess coronary risk in their patients? Preliminary results of the Coronary Health Assessment Study.BMJ. 1995; 3: 975
- Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study.Lancet Diabetes. 2015; 3 (114-22)
Article Info
Publication History
Published online: February 25, 2021
Accepted:
February 21,
2021
Received:
January 12,
2021
Footnotes
See page 789 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
