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 .
Does early intensive multifactorial therapy reduce modelled cardiovascular risk in individuals with screen-detected diabetes? Results from the ADDITION-Europe cluster randomized trial
Aims Little is known about the long-term effects of intensive multifactorial treatment early in the diabetes disease trajectory . In the absence of long-term data on hard outcomes , we described change in 10-year modelled cardiovascular risk in the 5 years following diagnosis , and quantified the impact of intensive treatment on 10-year modelled cardiovascular risk at 5 years . Methods In a pragmatic , cluster-r and omized , parallel-group trial in Denmark , the Netherl and s and the UK , 3057 people with screen-detected Type 2 diabetes were r and omized by general practice to receive ( 1 ) routine care of diabetes according to national guidelines ( 1379 patients ) or ( 2 ) intensive multifactorial target-driven management ( 1678 patients ) . Ten-year modelled cardiovascular disease risk was calculated at baseline and 5 years using the UK Prospect i ve Diabetes Study Risk Engine ( version 3β ) . Results Among 2101 individuals with complete data at follow up ( 73.4 % ) , 10-year modelled cardiovascular disease risk was 27.3 % ( sd 13.9 ) at baseline and 21.3 % ( sd 13.8 ) at 5-year follow-up ( intensive treatment group difference –6.9 , sd 9.0 ; routine care group difference –5.0 , sd 12.2 ) . Modelled 10-year cardiovascular disease risk was lower in the intensive treatment group compared with the routine care group at 5 years , after adjustment for baseline cardiovascular disease risk and clustering ( –2.0 ; 95 % CI –3.1 to –0.9 ) . Conclusions Despite increasing age and diabetes duration , there was a decline in modelled cardiovascular disease risk in the 5 years following diagnosis . Compared with routine care , 10-year modelled cardiovascular disease risk was lower in the intensive treatment group at 5 years . Our results suggest that patients benefit from intensive treatment early in the diabetes disease trajectory , where the rate of cardiovascular disease risk progression may be slowed
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 .