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 novel risk score to predict cardiovascular disease risk in national populations (Globorisk): a pooled analysis of prospective cohorts and health examination surveys.
BACKGROUND Treatment of cardiovascular risk factors based on disease risk depends on valid risk prediction equations . We aim ed to develop , and apply in example countries , a risk prediction equation for cardiovascular disease ( consisting here of coronary heart disease and stroke ) that can be recalibrated and up date d for application in different countries with routinely available information . METHODS We used data from eight prospect i ve cohort studies to estimate coefficients of the risk equation with proportional hazard regressions . The risk prediction equation included smoking , blood pressure , diabetes , and total cholesterol , and allowed the effects of sex and age on cardiovascular disease to vary between cohorts or countries . We developed risk equations for fatal cardiovascular disease and for fatal plus non-fatal cardiovascular disease . We vali date d the risk equations internally and also using data from three cohorts that were not used to create the equations . We then used the risk prediction equation and data from recent ( 2006 or later ) national health surveys to estimate the proportion of the population at different levels of cardiovascular disease risk in 11 countries from different world regions ( China , Czech Republic , Denmark , Engl and , Iran , Japan , Malawi , Mexico , South Korea , Spain , and USA ) . FINDINGS The risk score discriminated well in internal and external validations , with C statistics generally 70 % or more . At any age and risk factor level , the estimated 10 year fatal cardiovascular disease risk varied substantially between countries . The prevalence of people at high risk of fatal cardiovascular disease was lowest in South Korea , Spain , and Denmark , where only 5 - 10 % of men and women had more than a 10 % risk , and 62 - 77 % of men and 79 - 82 % of women had less than a 3 % risk . Conversely , the proportion of people at high risk of fatal cardiovascular disease was largest in China and Mexico . In China , 33 % of men and 28 % of women had a 10-year risk of fatal cardiovascular disease of 10 % or more , whereas in Mexico , the prevalence of this high risk was 16 % for men and 11 % for women . The prevalence of less than a 3 % risk was 37 % for men and 42 % for women in China , and 55 % for men and 69 % for women in Mexico . INTERPRETATION We developed a cardiovascular disease risk equation that can be recalibrated for application in different countries with routinely available information . The estimated percentage of people at high risk of fatal cardiovascular disease was higher in low-income and middle-income countries than in high-income countries . FUNDING US National Institutes of Health , UK Medical Research Council , Wellcome Trust
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 .