Primary prevention of cardiovascular disease: global cardiovascular risk assessment and management in clinical practice

European Heart Journal. Quality of Care & Clinical Outcomes
Tamryn K LawMilan Gupta

Abstract

For the primary prevention of cardiovascular disease, the Framingham Risk Score (FRS) is the most well-known risk prediction method. However, there are limited data regarding physicians' method of risk assessment and guideline adherence in clinical practice. In the PARADIGM (Primary cARe AuDIt of Global risk Management) study (March 2009-10), 105 primary care physicians across Canada prospectively collected data for 3015 patients (mean age 56 years, 59% men) without known cardiovascular disease, diabetes, or lipid-lowering medications at baseline. For each patient, the treating physician determined their cardiovascular risk, and reported the risk stratification method and subsequent treatment decisions. Kappa statistics assessed the agreement between the study-calculated FRS and the treating physician's reported risk assessment. The FRS was the most commonly reported risk assessment method, but was used in only 34.0% of patients. Regardless of the method used (even if the FRS was reportedly used), there was only fair agreement between the risk stratification as reported by the physician and the study-calculated FRS. Moreover, physicians recommended statin initiation in 92% of all patients that they identified as high risk; howe...Continue Reading

Associated Clinical Trials

References

Aug 5, 2006·The American Journal of Medicine·Andrew T YanUNKNOWN Vascular Protection (VP) and Guidelines Oriented Approach to Lipid Lowering (GOALL) Registries Investigators
Dec 7, 2007·The Canadian Journal of Cardiology·Daniel G HackamUNKNOWN Vascular Protection Registry and Guideline Oriented Appraoch to Lipid Lowering Registry Investigators
Jan 24, 2008·Circulation·Ralph B D'AgostinoWilliam B Kannel
Feb 25, 2009·Archives of Internal Medicine·Andrew T YanUNKNOWN Canadian Acute Coronary Syndrome Registry 2 Investigators
Feb 10, 2010·Archives of Internal Medicine·Stacey L SheridanUNKNOWN Cardiovascular Health Intervention Research and Translation Network Work Group on Global Coronary Heart Disease Risk
Jun 26, 2010·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Kornelia KotsevaUNKNOWN EUROASPIRE Study Group
Jan 24, 2012·The Canadian Journal of Cardiology·Milan GuptaSubodh Verma

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Citations

Oct 31, 2019·Journal of the American Geriatrics Society·Milly A van der PloegYvonne M Drewes
May 21, 2020·Journal of the American Heart Association·Min ZhaoSanne A E Peters
May 14, 2016·Autophagy·Jeffery HoWilliam K K Wu
Apr 1, 2016·European Heart Journal. Quality of Care & Clinical Outcomes·Julie George
Jul 1, 2015·European Heart Journal. Quality of Care & Clinical Outcomes·M Justin Zaman

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