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Cardiovascular risk assessment: a global perspective

  • Review Article
  • Published:

From Nature Reviews Cardiology

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Key Points

  • Cardiovascular disease (CVD) risk refers to the probability that an individual will experience an acute coronary or stroke event within a specific time period

  • CVD risk-assessment tools and appropriate recommendations for risk assessment in clinical guidelines are essential for implementation of a high-risk CVD prevention strategy in a population

  • CVD risk assessment depends not only on risk-factor profile, but also on the mean population CVD risk, mean population risk-factor levels, and relative risk of each risk factor

  • Specialized CVD risk-prediction models for different countries and diverse populations are necessary because risk-assessment tools developed for one population are often inaccurate when applied to another population

  • Prospective cohort studies with localized risk-assessment models are widely available, and might be used to develop localized risk-assessment tools in different regions, countries, or ethnic groups

  • Notable differences exist in CVD risk-assessment recommendations between clinical guidelines issued by different regions, countries, or organizations, and can affect decision-making in clinical practice

Abstract

An important strategy in primary prevention of cardiovascular diseases (CVD) is the early identification of high-risk individuals. Effective implementation of a strategy to identify these individuals in a clinical setting is reliant on the availability of appropriate CVD risk-assessment models and guideline recommendations. Several well-known models for CVD risk assessment have been developed and utilized in the USA and Europe, but might not be suitable for use in other regions or countries. Very few reports have discussed the development of risk-assessment models and recommendations from a global perspective. In this Review, we discuss why risk-assessment methods developed from studies in one geographical region or ethnic population might not be suitable for other regions or populations, and examine the availability and characteristics of predictive models in areas beyond the USA or Europe. In addition, we compare the differences in risk-assessment recommendations outlined in CVD clinical guidelines from developed and developing countries, and consider their potential effect on clinical practice. This overview of cardiovascular risk assessment from a global perspective can potentially guide low-to-middle-income countries in the development or validation of their own CVD risk-assessment models, and the formulation of recommendations in their own clinical guidelines according to local requirements.

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Authors and Affiliations

  1. Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, 100029, Beijing, China

    Dong Zhao, Jing Liu, Wuxiang Xie & Yue Qi

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  1. Dong Zhao
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D.Z. and J.L. researched data for the article, discussed its content, and wrote, reviewed, and edited the manuscript before submission. W.X. and Y.Q. also researched data for the article, discussed its content, and reviewed and edited the manuscript before submission.

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Correspondence to Dong Zhao.

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Definition of outcome and risk factors in cardiovascular disease risk assessment models among diverse populations (PDF 76 kb)

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Zhao, D., Liu, J., Xie, W. et al. Cardiovascular risk assessment: a global perspective. Nat Rev Cardiol 12, 301–311 (2015). https://doi.org/10.1038/nrcardio.2015.28

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