Work

Can cardiovascular disease guidelines that advise treatment decisions based on absolute risk be improved?

Year: 2016

Type: review

Abstract: BACKGROUND: Cardiovascular disease (CVD) will remain the predominant cause of death and a major cause of morbidity for the foreseeable future. Consequently, CVD prevention offers the greatest potential for the prevention of premature mortality and the compression of morbidity. DISCUSSION: The 2013 guidelines of the American College of Cardiology and the American Heart Association expand the eligibility for CVD preventive treatment based on the calculated 10-year CVD risk derived from the pooled cohort equation to all persons who have a 10-year risk of CVD of ≥7.5% as estimated by the pooled cohort equation. Previous analyses show that the use of a uniform 10-year risk threshold of 7.5% for all ages disadvantages younger individuals for whom preventive therapy has most to offer. Here I show that reducing the threshold to 3% in younger adults (women aged <66 years and men aged <56 years) will substantially increase the number of cardiovascular events prevented at a similar number needed to treat to prevent one event. Importantly, this increase in cardiovascular event prevention will occur in individuals with greater life expectancy. CONCLUSION: Reducing the threshold 10-year risk of CVD derived from the pooled cohort equation for CVD preventive treatment to 3% in younger adults (women aged <66 years and men aged <56 years) will more effectively prevent premature mortality and compress morbidity to an older age.

Source: BMC Cardiovascular Disorders

DOI: 10.1186/s12872-016-0396-y

Author: Duncan J. Campbell

Institutions: The University of Melbourne, St Vincents Institute of Medical Research

Language: English

Topic: Health Promotion and Cardiovascular Prevention

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090