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 .
Care manager to control cardiovascular risk factors in primary care: the Raffaello cluster randomized trial.
BACKGROUND AND AIM This cluster r and omized trial evaluated the efficacy of a disease and care management ( D&CM ) model in  cardiovascular ( CVD ) prevention in primary care . METHODS AND RESULTS Eligible subjects had ≥ 1 among : blood pressure ≥ 140/90 mmHg ; glycated hemoglobin ≥ 7 % ; LDL-cholesterol ≥ 160 or ≥ 100 mg/dL ( primary or secondary prevention , respectively ) ; BMI ≥ 30 ; current smoking .  The D&CM intervention included a teamwork including nurses as care managers for the implementation of tailored care plans . Control group was allocated to usual-care . The main outcome was the proportion of subjects achieving recommended clinical targets for ≥ 1 of uncontrolled CVD risk factors at 12-month . During 2008 - 2009 we enrolled 920 subjects in the Abruzzo/Marche regions , Italy . Following the exclusion of L'Aquila due to 2009 earthquake , final analyses included 762 subjects . The primary outcome was achieved by 39.1 % ( 95%CI : 34.2 - 44.2 ) and 25.2 % ( 95%CI : 20.9 - 29.9 ) of subjects in the intervention and usual-care group , respectively ( p < 0.001 ) . The D&CM intervention significantly increased the proportion of subjects who achieved clinical targets for both diabetes and hypertension , with no differences in hypercholesterolemia , smoking status and obesity . CONCLUSIONS The D&CM intervention  was effective in controlling cardiovascular risk factors , in particular hypertension and diabetes . Numbers needed to treat were small . Such intervention may deserve further consideration in clinical practice . REGISTRATION NUMBER ACTRN12611000813987
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 .