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 primary care cardiovascular risk reduction clinic in Canada was more effective and no more expensive than usual on-demand primary care--a randomised controlled trial.
The objective of this r and omised controlled trial was to compare the effects and expense of three approaches to care ( 1 ) proactive cardiovascular risk reduction ( CaRR ) clinic ; ( 2 ) nurse telephone calls ; or ( 3 ) usual care for people with cardiovascular risk factors in a Primary Care , Health Service Organisation ( HSO ) in Ontario , Canada . Subjects included consenting patients with an identified cardiovascular disease ( CVD ) risk factor identified from the HSO computerised patient information system in 2004 . Patients were excluded if they were mentally incompetent , < 18 years of age , in a nursing home , or not English speaking . Of 1570 eligible subjects , 523 ( 33.3 % ) verbally declined , 145 ( 9.2 % ) could not be contacted , and 249 ( 15.9 % ) were not needed . The final sample size was 653 ( 41.6 % ) , 634 completed the follow-up ( 97 % ) . The Cardiovascular Risk Score , Health and Social Service Utilisation , Montgomery-Asberg Depression Rating , Billings and Moos Indices of Coping , Personal Re source and Self-Efficacy Question naires were measured at baseline and 1-year follow-up by clinical examination and telephone interview . Cardiovascular risk scores were reduced in all treatment groups after 1 year . The proportions of subjects showing reduction in risk score greater than or equal to 10 % was greatest in the CaRR group ( 69.2 % ) compared with Nurse Phone intervention ( 57.8 % ) and Usual Care ( 59.0 % ) ( M-Hchi(2 ) = 4.33 , df = 1 , P = 0.037 , CaRR-Usual Care ) . Self-efficacy scores showed the greatest improvements in the CaRR clinic . This effect was achieved with no significant difference in total person per annum costs for direct and indirect health and social service utilisation between all three groups . A CaRR clinic is more effective in reducing CVD risk after 1 year compared with nurse phone intervention and usual care with no additional expense found
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 .