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 .
A self-determination multiple risk intervention trial to improve smokers’ health
Abstract BACKGROUND : Little is known about how interventions motivate individuals to change multiple health risk behaviors . Self-determination theory ( SDT ) proposes that patient autonomy is an essential factor for motivating change . OBJECTIVE : An SDT-based intervention to enhance autonomous motivation for tobacco abstinence and improving cholesterol was tested . DESIGN : The Smokers ’ Health Study is a r and omized multiple risk behavior change intervention trial . SETTING : Smokers were recruited to a tobacco treatment center . PATIENTS : A total of 1,006 adult smokers were recruited between 1999 and 2002 from physician offices and by newspaper advertisements . INTERVENTIONS : A 6-month clinical intervention ( 4 contacts ) to facilitate internalization of autonomy and perceived competence for tobacco abstinence and reduced percent calories from fat was compared with community care . Clinicians elicited patient perspectives and life strivings , provided absolute coronary artery disease risk estimates , enumerated effective treatment options , supported patient initiatives , minimized clinician control , assessed motivation for change , and developed a plan for change . MAIN OUTCOME MEASURES : Twelve-month prolonged tobacco abstinence , and change in percent calories from fat and low-density lipoprotein-cholesterol ( LDL-C ) from baseline to 18 months . RESULTS : Intention to treat analyses revealed that the intervention significantly increased 12-month prolonged tobacco abstinence ( 6.2 % vs 2.4 % ; odds ratio [OR]=2.7,P=.01 , number needed to treat [NNT]=26 ) , and reduced LDL-C ( −8.9 vs −4.1 mg/dL;P=.05 ) . There was no effect on percent calories from fat . CONCLUSIONS : An intervention focused on supporting smokers ’ autonomy was effective in increasing prolonged tobacco abstinence and lowering LDL-C. Clinical interventions for behavior change may be improved by increasing patient autonomy and perceived competence
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 .