There is uncertainty whether current strategies for providing CVD risk scores  affect CVD events .
Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher-risk people without evidence of harm .
BACKGROUND The current paradigm for cardiovascular disease ( CVD ) emphasises absolute risk assessment to guide treatment decisions in primary prevention .
Although the derivation and validation of multivariable risk assessment tools , or CVD risk scores , have attracted considerable attention , their effect on clinical outcomes is uncertain .
OBJECTIVES To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes , risk factor levels , preventive medication prescribing , and health behaviours .
Effect of Nurse Case Management Compared With Usual Care on Controlling Cardiovascular Risk Factors in Patients With Diabetes
OBJECTIVE To determine whether nurse case management with a therapeutic algorithm could effectively improve rates of control for hypertension , hyperglycemia , and hyperlipidemia compared with usual care among veterans with diabetes . RESEARCH DESIGN AND METHODS A r and omized controlled trial of diabetic patients that had blood pressure ( BP ) > 140/90 mmHg , hemoglobin A1c ( HbA1c ) > 9.0 % , or LDL > 100 mg/dL. Intervention patients received case management ( n = 278 ) versus usual care ( n = 278 ) over a 1-year period . The primary outcome was the percentage of patients achieving simultaneous control of all three parameters ( defined by BP < 130/80 mmHg , HbA1c < 8.0 % , and LDL < 100 mg/dL ) at 1 year . Secondary outcomes included improvements within each individual component of the composite primary outcome . Differences between groups were analyzed using t tests , Pearson χ2 tests , and linear and logistic regression . RESULTS A greater number of individuals assigned to case management achieved the primary study outcome of having all three outcome measures under control ( 61 [ 21.9 % ] compared with 28 [ 10.1 % ] in the usual care group [ P < 0.01 ] ) . In addition , a greater number of individuals assigned to the intervention group achieved the individual treatment goals of HbA1c < 8.0 % ( 73.7 vs. 65.8 % , P = 0.04 ) and BP < 130/80 mmHg ( 45.0 vs. 25.4 % , P < 0.01 ) , but not for LDL < 100 mg/dL ( 57.6 vs. 55.4 % , P = 0.61 ) , compared with those in the usual care group . CONCLUSIONS In patients with diabetes , nurse case managers using a treatment algorithm can effectively improve the number of individuals with control of multiple cardiovascular risk factors at 1 year
There is uncertainty whether current strategies for providing CVD risk scores  affect CVD events .
Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher-risk people without evidence of harm .
BACKGROUND The current paradigm for cardiovascular disease ( CVD ) emphasises absolute risk assessment to guide treatment decisions in primary prevention .
Although the derivation and validation of multivariable risk assessment tools , or CVD risk scores , have attracted considerable attention , their effect on clinical outcomes is uncertain .
OBJECTIVES To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes , risk factor levels , preventive medication prescribing , and health behaviours .