PMID: 18196656Jan 17, 2008Paper

Overestimation and underestimation of cardiovascular risk in clinical practice: usefulness of risk estimation charts

Hellenic Journal of Cardiology : HJC = Hellēnikē Kardiologikē Epitheōrēsē
Athanasios PipilisKonstantinos Mallios

Abstract

Charts for the estimation of cardiovascular risk contribute greatly to clinical decision making in the management of asymptomatic individuals. However, most decisions are taken without consulting the charts. The aim of our study was to record the degree of overestimation or underestimation of cardiovascular risk in everyday clinical practice. Seven cases of asymptomatic individuals at different levels of cardiovascular risk as a result of different combinations of risk factors (one at very low, one at very high and five at intermediate risk) were presented in random order to 30 doctors who deal with primary prevention consultations in their daily clinical practice. They were asked if hypolipidaemic therapy was needed and their answers were compared with the recommended management of the current European guidelines on prevention using the risk charts of the European Society of Cardiology. The mean percentage of agreement was 70%. In the two extreme cases agreement with the guidelines was absolute, but in the intermediate cases it varied widely. Particularly in those cases with cholesterol level 200-240 mg/dl it was just 40%, due either to overestimation or to underestimation of the risk. In the cases of obviously low or obviousl...Continue Reading

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