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 .
Individualized Risk Communication and Outreach for Primary Cardiovascular Disease Prevention in Community Health Centers: Randomized Trial
Background —Many eligible primary cardiovascular disease prevention c and i date s are not treated with statins . Electronic health record data can identify patients with increased cardiovascular disease risk . Methods and Results —We performed a pragmatic r and omized controlled trial at community health centers in 2 states . Participants were men aged ≥35 years and women ≥45 years , without cardiovascular disease or diabetes mellitus , and with a 10-year risk of coronary heart disease of at least 10 % . The intervention group received telephone and mailed outreach , individualized based on patients ’ cardiovascular disease risk and uncontrolled risk factors , provided by lay health workers . Main outcomes included : documented discussion of medication treatment for cholesterol with a primary care clinician , receipt of statin prescription within 6 months , and low-density lipoprotein (LDL)-cholesterol repeated and at least 30 mg/dL lower than baseline within 1 year . Six hundred forty-six participants ( 328 and 318 in the intervention and control groups , respectively ) were included . At 6 months , 26.8 % of intervention and 11.6 % of control patients had discussed cholesterol treatment with a primary care clinician ( odds ratio , 2.79 ; [ 95 % confidence interval , 2.25–3.46 ] ) . Statin prescribing occurred for 10.1 % in the intervention group and 6.0 % in the control group ( odds ratio , 1.76 ; [ 95 % confidence interval , 0.90–3.45 ] ) . The cholesterol outcome did not differ , and the majority of patients did not repeat lipid levels during follow-up . Conclusions —Risk communication and lay outreach increased cholesterol treatment discussion s with primary care clinicians . However , most discussion s did not result in statin prescribing . For outreach to be successful , it should be combined with interventions to encourage clinicians to follow contemporary risk-based cholesterol treatment guidelines . Clinical Trial Registration —URL : http://www.clincialtrials.gov . Unique identifier : NCT01610609
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 .