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 .
Implementing cardiac risk-factor case management: lessons learned in a county health system.
METHODS Case-management ( CM ) can positively influence chronic disease care by facilitating guideline -concordant interventions that improve outcomes through intensive , individualized , longitudinal care . Implementation of CM , however , is difficult . We have identified lessons learned from a cardiovascular risk reduction CM program that may aid future CM implementation . INTRODUCTION Heart to Heart is both a clinical trial and program dissemination project implementing CM for persons at elevated risk of coronary heart disease ( CHD ) events in a multiethnic , low-income population in a county health system . Patients were r and omized to CM plus usual primary care ( N = 212 ) or primary care alone ( N = 207 ) . CM  patients received face-to-face nurse and dietitian visits ( mean of 14 hours ) over 17 months . Visits emphasized behavior change , risk-factor monitoring , and guideline -based pharmacotherapy . A total of 341 patients ( 81 % ) were available for follow-up . This CM model is currently transitioning to a County-run program . RESULTS Findings demonstrated statistically significant reductions in mean Framingham Risk for CM versus usual primary care ( 1.56 % absolute decrease in 10-year CHD risk , P = 0.007 ) . Favorable changes were noted across most major CHD risk factors . Lessons learned are the need for the following : ( 1 ) Strategies for implementing CM in low-income , ethnically-diverse population s , ( 2 ) Methods for developing clinical ly more effective CM , and ( 3 ) Approaches to increase the  efficiency of cardiovascular CM . CONCLUSIONS CM for cardiac risk factors faces notable implementation barriers , particularly in County health systems . Specific implementation solutions recommended may help confront these barriers and improve diffusion of this evidence -based and patient centered model of care
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 .