Abstract
Prevention is now recognized as a first-line approach in the management of atherosclerotic cardiovascular disease (CVD), in both the Western World (Lloyd-Jones et al. (Circulation 121:586–613, 2010), Goff et al. (Circulation, 2013a), Perk et al. (Eur Heart J 33:1635–1701, 2012)) and internationally (Sacco et al. (Lancet 382:e4–e5, 2013)). Over the past six decades, epidemiologic investigation, the science most relevant to establishing means of prevention, has identified the major “risk factors” that contribute to the development of atherosclerotic CVD and its components: coronary heart disease, stroke, and peripheral artery disease (Kannel (J Am Coll Cardiol 15:206–211, 1990)). Because the major “risk factors” are modifiable, and their treatment reduces the likelihood of developing vascular disease, risk factor assessment has become an important feature of primary and secondary prevention of CVD.
The major modifiable cardiovascular risk factors with evidence for a strong independent relationship to CVD can be readily ascertained by ordinary office procedures (Kannel (J Am Coll Cardiol 15:206–211, 1990)). Prospective community-based studies like the Framingham Heart Study have documented the relevance of systolic blood pressure, blood lipids, glucose intolerance and adult-onset diabetes mellitus, and cigarette smoking to assess the propensity for a first atherosclerotic CVD event. Using these risk factors, which are common to all major atherosclerotic cardiovascular events, and a number of other predisposing factors specific to stroke and peripheral arterial disease, multivariate risk formulations have been produced for estimating the global risk of events as a function of the burden of coexisting risk factors (Wilson et al. (Circulation 97:1837–1847, 1998), Wolf et al. (Stroke 22:312–318, 1991), Murabito et al. (Circulation 96:44–49, 1997), D’Agostino et al. (Circulation 117:743–753, 2008)). Recent epidemiological research has brought attention to the potential role of newer risk markers measured in circulating blood, high-resolution subclinical vascular disease imaging modalities, and genetic and genomic factors underlying CVD. However, as of yet, there is insufficient evidence to recommend most of these newer measures in clinical practice (Goff et al. (J Am Coll Cardiol, 2013b)).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Andersson C, Vasan RS (2014) Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: clinical risk scores are sufficient to define primary prevention treatment strategies among asymptomatic patients. Circ Cardiovasc Imaging 7:390–397
Ankle Brachial Index C, Fowkes FG, Murray GD et al (2008) Ankle brachial index combined with Framingham risk score to predict cardiovascular events and mortality: a meta-analysis. JAMA 300:197–208
Bastos Goncalves F, Voute MT, Hoeks SE et al (2012) Calcification of the abdominal aorta as an independent predictor of cardiovascular events: a meta-analysis. Heart 98:988–994
Bedi US, Singh M, Singh PP et al (2010) Effects of statins on progression of carotid atherosclerosis as measured by carotid intimal–medial thickness: a meta-analysis of randomized controlled trials. J Cardiovasc Pharmacol Ther 15:268–273
Berry JD, Dyer A, Cai X et al (2012) Lifetime risks of cardiovascular disease. N Engl J Med 366:321–329
Bis JC, Kavousi M, Franceschini N et al (2011) Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque. Nat Genet 43:940–947
Bots ML, Taylor AJ, Kastelein JJ et al (2012) Rate of change in carotid intima-media thickness and vascular events: meta-analyses cannot solve all the issues. A point of view. J Hypertens 30:1690–1696
Budoff MJ, Nasir K, McClelland RL et al (2009) Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 53:345–352
Celermajer DS, Chow CK, Marijon E, Anstey NM, Woo KS (2012) Cardiovascular disease in the developing world: prevalences, patterns, and the potential of early disease detection. J Am Coll Cardiol 60:1207–1216
Centers for Disease C, Prevention (2011) Prevalence of coronary heart disease–United States, 2006–2010. MMWR Morb Mortal Wkly Rep 60:1377–1381
Centers for Disease C, Prevention (2012) Prevalence of stroke–United States, 2006–2010. MMWR Morb Mortal Wkly Rep 61:379–382
Chatterjee N, Wheeler B, Sampson J, Hartge P, Chanock SJ, Park JH (2013) Projecting the performance of risk prediction based on polygenic analyses of genome-wide association studies. Nat Gen 45:400–405, 405e1-3
Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL (2012) Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet 379:905–914
Conroy RM, Pyorala K, Fitzgerald AP et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003
Consortium CAD, Deloukas P, Kanoni S et al (2013) Large-scale association analysis identifies new risk loci for coronary artery disease. Nat Genet 45:25–33
Costanzo P, Perrone-Filardi P, Vassallo E et al (2010) Does carotid intima-media thickness regression predict reduction of cardiovascular events? A meta-analysis of 41 randomized trials. J Am Coll Cardiol 56:2006–2020
D’Agostino RB Sr, Grundy S, Sullivan LM, Wilson P, Group CHDRP (2001) Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA 286:180–187
D’Agostino RB Sr, Vasan RS, Pencina MJ et al (2008) General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation 117:743–753
Detrano R, Guerci AD, Carr JJ et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345
Dong C, Rundek T, Wright CB, Anwar Z, Elkind MS, Sacco RL (2012) Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and hispanics: the northern Manhattan study. Circulation 125:2975–2984
Expert Panel on Detection E, Treatment of High Blood Cholesterol in A (2001) Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285:2486–2497
Ference BA, Yoo W, Alesh I et al (2012) Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. J Am Coll Cardiol 60:2631–2639
Finn AV, Kolodgie FD, Virmani R (2010) Correlation between carotid intimal/medial thickness and atherosclerosis: a point of view from pathology. Arterioscler Thromb Vasc Biol 30:177–181
Flegal KM, Carroll MD, Kit BK, Ogden CL (2012) Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 307:491–497
Folsom AR, Yatsuya H, Nettleton JA et al (2011) Community prevalence of ideal cardiovascular health, by the American Heart Association definition, and relationship with cardiovascular disease incidence. J Am Coll Cardiol 57:1690–1696
Ford ES, Ajani UA, Croft JB et al (2007) Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med 356:2388–2398
Fox CS, Polak JF, Chazaro I et al (2003) Genetic and environmental contributions to atherosclerosis phenotypes in men and women: heritability of carotid intima-media thickness in the Framingham heart study. Stroke 34:397–401
Ganna A, Magnusson PK, Pedersen NL et al (2013) Multilocus genetic risk scores for coronary heart disease prediction. Arterioscler Thromb Vasc Biol 33:2267–2272
Go AS, Mozaffarian D, Roger VL et al (2013) Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 127:e6–e245
Go AS, Mozaffarian D, Roger VL et al (2014) Executive summary: heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation 129:399–410
Goff DC Jr, Lloyd-Jones DM, Bennett G et al (2013a) ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American college of cardiology/American heart association task force on practice guidelines. Circulation 129(25 Suppl 2):S1–45.
Goff DC Jr, Lloyd-Jones DM, Bennett G et al (2013b) ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American college of cardiology/American heart association task force on practice guidelines. J Am Coll Cardiol
Goldberger ZD, Valle JA, Dandekar VK, Chan PS, Ko DT, Nallamothu BK (2010) Are changes in carotid intima-media thickness related to risk of nonfatal myocardial infarction? A critical review and meta-regression analysis. Am Heart J 160:701–714
Greenland P, Alpert JS, Beller GA et al (2010) 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. Circulation 122:2748–2764
Grundy SM, Cleeman JI, Merz CN et al (2004) Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation 110:227–239
Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P (2007) Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ 335:136
Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Brindle P (2008) Performance of the QRISK cardiovascular risk prediction algorithm in an independent UK sample of patients from general practice: a validation study. Heart 94:34–39
Hlatky MA, Greenland P, Arnett DK et al (2009) Criteria for evaluation of novel markers of cardiovascular risk: a scientific statement from the American Heart Association. Circulation 119:2408–2416
Hoffmann U, Massaro JM, Fox CS, Manders E, O’Donnell CJ (2008) Defining normal distributions of coronary artery calcium in women and men (from the Framingham Heart Study). Am J Cardiol 102:1136–1141, 1141 e1
Holmes MV, Asselbergs FW, Palmer TM et al (2014) Mendelian randomization of blood lipids for coronary heart disease. Eur Heart J
http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf
Huang Y, Li W, Dong L, Li R, Wu Y (2013) Effect of statin therapy on the progression of common carotid artery intima-media thickness: an updated systematic review and meta-analysis of randomized controlled trials. J Atheroscler Thromb 20:108–121
Hulten E, Villines TC, Cheezum MK et al (2014) Calcium score, coronary artery disease extent and severity, and clinical outcomes among low Framingham risk patients with low vs high lifetime risk: results from the CONFIRM registry. J Nucl Cardiol 21:29–37; quiz 38–9
Ikram MA, Seshadri S, Bis JC et al (2009) Genomewide association studies of stroke. N Engl J Med 360:1718–1728
Inaba Y, Chen JA, Bergmann SR (2012) Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis. Atherosclerosis 220:128–133
Ingelsson E, Sullivan LM, Murabito JM et al (2007a) Prevalence and prognostic impact of subclinical cardiovascular disease in individuals with the metabolic syndrome and diabetes. Diabetes 56:1718–1726
Ingelsson E, Sullivan LM, Fox CS et al (2007b) Burden and prognostic importance of subclinical cardiovascular disease in overweight and obese individuals. Circulation 116:375–384
Iribarren C, Sidney S, Sternfeld B, Browner WS (2000) Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA 283:2810–2815
Kannel WB, Gordon T, Offutt D (1969) Left ventricular hypertrophy by electrocardiogram. Prevalence, incidence, and mortality in the Framingham study. Ann Intern Med 71:89–105
Kannel WB, Gordon T, Castelli WP, Margolis JR (1970) Electrocardiographic left ventricular hypertrophy and risk of coronary heart disease. The Framingham study. Ann Intern Med 72:813–822
Kannel WB, Wilson PW, Moser M, Rich MW (1998) What older adults should know about high cholesterol: a position paper from the Society of Geriatric Cardiology. Am J Geriatr Cardiol 7:43–44
Kelley MJ, Newell JD (1983) Chest radiography and cardiac fluoroscopy in coronary artery disease. Cardiol Clin 1:575–595
Koriyama H, Nakagami H, Katsuya T et al (2010) Identification of evidence suggestive of an association with peripheral arterial disease at the OSBPL10 locus by genome-wide investigation in the Japanese population. J Atheroscler Thromb 17:1054–1062
Kuller L, Borhani N, Furberg C et al (1994) Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the cardiovascular health study. Am J Epidemiol 139:1164–1179
Kuller LH, Shemanski L, Psaty BM et al (1995) Subclinical disease as an independent risk factor for cardiovascular disease. Circulation 92:720–726
Kullo IJ, Turner ST, Kardia SL, Mosley TH Jr, Boerwinkle E, de Andrade M (2006) A genome-wide linkage scan for ankle-brachial index in African American and non-Hispanic white subjects participating in the GENOA study. Atherosclerosis 187:433–438
Laslett LJ, Alagona P Jr, Clark BA 3rd et al (2012) The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol 60:S1–S49
Levitzky YS, Cupples LA, Murabito JM et al (2008) Prediction of intermittent claudication, ischemic stroke, and other cardiovascular disease by detection of abdominal aortic calcific deposits by plain lumbar radiographs. Am J Cardiol 101:326–331
Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566
Lin JS, Olson CM, Johnson ES, Senger CA, Soh CB, Whitlock EP (2013) The ankle brachial index for peripheral artery disease screening and cardiovascular disease prediction in asymptomatic adults: a systematic evidence review for the US preventive services task force. Agency for Healthcare Research and Quality, Rockville
Linsel-Nitschke P, Gotz A, Erdmann J et al (2008) Lifelong reduction of LDL-cholesterol related to a common variant in the LDL-receptor gene decreases the risk of coronary artery disease–a Mendelian Randomization study. PLoS One 3:e2986
Liu J, Hong Y, D’Agostino RB Sr et al (2004) Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese multi-provincial cohort study. JAMA 291:2591–2599
Lloyd-Jones DM, Nam BH, D’Agostino RB Sr et al (2004) Parental cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults: a prospective study of parents and offspring. JAMA 291:2204–2211
Lloyd-Jones DM, Hong Y, Labarthe D et al (2010) Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation 121:586–613
Lorenz MW, Polak JF, Kavousi M et al (2012) Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. Lancet 379:2053–2062
Marenberg ME, Risch N, Berkman LF, Floderus B, de Faire U (1994) Genetic susceptibility to death from coronary heart disease in a study of twins. N Engl J Med 330:1041–1046
McClelland RL, Chung H, Detrano R, Post W, Kronmal RA (2006) Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 113:30–37
Min JK, Dunning A, Lin FY et al (2011) Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol 58:849–860
Muntner P, Colantonio LD, Cushman M et al (2014) Validation of the atherosclerotic cardiovascular disease pooled cohort risk equations. JAMA
Murabito JM, D’Agostino RB, Silbershatz H, Wilson WF (1997) Intermittent claudication. A risk profile from the Framingham heart study. Circulation 96:44–49
Murabito JM, Pencina MJ, Nam BH et al (2005) Sibling cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults. JAMA 294:3117–3123
Murabito JM, Guo CY, Fox CS, D’Agostino RB (2006) Heritability of the ankle-brachial index: the Framingham offspring study. Am J Epidemiol 164:963–968
Murray CJ, Lopez AD (2013) Measuring the global burden of disease. N Engl J Med 369:448–457
Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF (2003) Lifetime risk for diabetes mellitus in the United States. JAMA 290:1884–1890
Ng M, Freeman MK, Fleming TD et al (2014) Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA 311:183–192
NIH Consensus conference (1993) Triglyceride, high-density lipoprotein, and coronary heart disease. NIH consensus development panel on triglyceride, high-density lipoprotein, and coronary heart disease. JAMA 269:505–510
O’Donnell CJ, Nabel EG (2011) Genomics of cardiovascular disease. N Engl J Med 365:2098–2109
O’Donnell CJ, Chazaro I, Wilson PW et al (2002) Evidence for heritability of abdominal aortic calcific deposits in the Framingham heart study. Circulation 106:337–341
O’Donnell CJ, Kavousi M, Smith AV et al (2011) Genome-wide association study for coronary artery calcification with follow-up in myocardial infarction. Circulation 124:2855–2864
O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr (1999) Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 340:14–22
Paynter NP, Chasman DI, Pare G et al (2010) Association between a literature-based genetic risk score and cardiovascular events in women. JAMA 303:631–637
Pencina MJ, Navar-Boggan AM, D’Agostino RB Sr et al (2014) Application of new cholesterol guidelines to a population-based sample. New Engl J Med
Peyser PA, Bielak LF, Chu JS et al (2002) Heritability of coronary artery calcium quantity measured by electron beam computed tomography in asymptomatic adults. Circulation 106:304–308
Polak JF, Pencina MJ, Pencina KM, O’Donnell CJ, Wolf PA, D’Agostino RB Sr (2011) Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med 365:213–221
Polonsky TS, Greenland P (2012) CVD screening in low-risk, asymptomatic adults: clinical trials needed. Nat Rev Cardiol 9:599–604
Polonsky TS, McClelland RL, Jorgensen NW et al (2010) Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 303:1610–1616
Reaven G (2002) Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 106:286–288
Ridker PM, Buring JE, Rifai N, Cook NR (2007) Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds risk score. JAMA 297:611–619
Ridker PM, Paynter NP, Rifai N, Gaziano JM, Cook NR (2008) C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men. Circulation 118:2243–2251, 4p following 2251
Ripatti S, Tikkanen E, Orho-Melander M et al (2010) A multilocus genetic risk score for coronary heart disease: case–control and prospective cohort analyses. Lancet 376:1393–1400
Schiller JS, Lucas JW, Ward BW, Peregoy JA (2012) Summary health statistics for U.S. adults: National Health Interview Survey, 2010. Vital and health statistics Series 10, Data from the National Health Survey 1–207
Seshadri S, Beiser A, Pikula A et al (2010) Parental occurrence of stroke and risk of stroke in their children: the Framingham study. Circulation 121:1304–1312
Stone NJ, Robinson J, Lichtenstein AH et al (2013) ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American college of cardiology/American heart association task force on practice guidelines. Circulation
Thanassoulis G, Peloso GM, Pencina MJ et al (2012) A genetic risk score is associated with incident cardiovascular disease and coronary artery calcium: the Framingham Heart Study. Circ Cardiovasc Genet 5:113–121
Thanassoulis G, Peloso GM, O’Donnell CJ (2013) Genomic medicine for improved prediction and primordial prevention of cardiovascular disease. Arterioscler Thromb Vasc Biol 33:2049–2050
Tikkanen E, Havulinna AS, Palotie A, Salomaa V, Ripatti S (2013) Genetic risk prediction and a 2-stage risk screening strategy for coronary heart disease. Arterioscler Thromb Vasc Biol 33:2261–2266
Triglyceride Coronary Disease Genetics C, Emerging Risk Factors C, Sarwar N et al (2010) Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies. Lancet 375:1634–1639
Tropeano AI, Saleh N, Hawajri N, Macquin-Mavier I, Maison P (2011) Do all antihypertensive drugs improve carotid intima-media thickness? A network meta-analysis of randomized controlled trials. Fundam Clin Pharmacol 25:395–404
Vasan RS, Beiser A, Seshadri S et al (2002) Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study. JAMA 287:1003–1010
Vasan RS, Pencina MJ, Cobain M, Freiberg MS, D’Agostino RB (2005) Estimated risks for developing obesity in the Framingham heart study. Ann Intern Med 143:473–480
Voight BF, Peloso GM, Orho-Melander M et al (2012) Plasma HDL cholesterol and risk of myocardial infarction: a Mendelian randomization study. Lancet 380:572–580
Wang JG, Staessen JA, Li Y et al (2006) Carotid intima-media thickness and antihypertensive treatment: a meta-analysis of randomized controlled trials. Stroke 37:1933–1940
Webber BJ, Seguin PG, Burnett DG, Clark LL, Otto JL (2012) Prevalence of and risk factors for autopsy-determined atherosclerosis among US service members, 2001–2011. JAMA 308:2577–2583
Weinberg I, Gona P, O’Donnell CJ, Jaff MR, Murabito JM (2014) The systolic blood pressure difference between arms and cardiovascular disease in the Framingham heart study. Am J Med 127:209–215
Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97:1837–1847
Wilson PW, Kauppila LI, O’Donnell CJ et al (2001) Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality. Circulation 103:1529–1534
Wilson PW, Pencina M, Jacques P, Selhub J, D’Agostino R Sr, O’Donnell CJ (2008) C-reactive protein and reclassification of cardiovascular risk in the Framingham heart study. Circ Cardiovasc Qual Outcomes 1:92–97
Witteman JC, Kannel WB, Wolf PA et al (1990) Aortic calcified plaques and cardiovascular disease (the Framingham study). Am J Cardiol 66:1060–1064
Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB (1991) Probability of stroke: a risk profile from the Framingham Study. Stroke 22:312–318
Woodward M, Brindle P, Tunstall-Pedoe H, estimation Sgor (2007) Adding social deprivation and family history to cardiovascular risk assessment: the ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 93:172–176
Yang Q, Cogswell ME, Flanders WD et al (2012) Trends in cardiovascular health metrics and associations with all-cause and CVD mortality among US adults. JAMA 307:1273–1283
Yeboah J, McClelland RL, Polonsky TS et al (2012) Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA 308:788–795
Further Reading
Labarthe DR (2010) Epidemiology and prevention of cardiovascular diseases: a global challenge, 2nd edn. Jones & Bartlett, Boston
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg (outside the USA)
About this entry
Cite this entry
Andersson, C., O’Donnell, C.J. (2015). Epidemiology of Atherosclerotic Vascular Diseases. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_46
Download citation
DOI: https://doi.org/10.1007/978-3-642-37078-6_46
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-37077-9
Online ISBN: 978-3-642-37078-6
eBook Packages: MedicineReference Module Medicine