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 .
Changes in CVD risk factors in the activity counseling trial
Primary care facilities may be a natural setting for delivering interventions that focus on behaviors that improve cardiovascular disease ( CVD ) risk factors . The purpose of this study was to examine the 24-month effects of the Activity Counseling Trial ( ACT ) on CVD risk factors , to examine whether changes in CVD risk factors differed according to baseline risk factor status , and to examine whether changes in fitness were associated with changes in CVD risk factors . ACT was a 24-month multicenter r and omized controlled trial to increase physical activity .  Participants were 874 inactive men and women aged 35–74 years . Participants were r and omly assigned to one of three arms that varied by level of counseling , intensity , and re source requirements . Because there were no significant differences in change over time between arms on any of the CVD risk factors examined , all arms were combined , and the effects of time , independent of arm , were examined separately for men and women . Time × Baseline risk factor status interactions examined whether changes in CVD risk factors differed according to baseline risk factor status . Significant improvements in total cholesterol , high-density lipoprotein cholesterol ( HDL-C ) and low-density lipoprotein cholesterol , the ratio of total cholesterol to HDL-C , and triglycerides were seen in both men and women who had high ( or low for HDL-C ) baseline levels of risk factors , whereas significant improvements in diastolic blood pressure were seen only in those men with high baseline levels . There were no improvements in any risk factors among participants with normal baseline levels . Changes in fitness were associated with changes in a number of CVD risk factors . However , most relationships disappeared after controlling for changes in body weight . Improvements in lipids from the ACT interventions could reduce the risk of coronary heart disease in people with already high levels of lipids by 16%–26 % in men and 11%–16 % in women . Interventions that can be implemented in health care setting s nationwide and result in meaningful population -wide changes in CVD risk factors are needed . The ACT physical activity interventions produced substantial improvements among men and women with elevated CVD risk factors
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 .