Limited data suggest that systematic risk assessment for CVD has no statistically significant effects on clinical endpoints .
There is limited evidence to suggest that CVD systematic risk assessment may have some favourable effects on cardiovascular risk factors .
BACKGROUND Screening programmes can potentially identify people at high cardiovascular risk and reduce cardiovascular disease ( CVD ) morbidity and mortality .
However , there is currently not enough evidence showing clear clinical or economic benefits of systematic screening-like programmes over the widely practised opportunistic risk assessment of CVD in primary care setting s. OBJECTIVES The primary objective of this review was to assess the effectiveness , costs and adverse effects of systematic risk assessment compared to opportunistic risk assessment for the primary prevention of CVD .
Effects of a global risk educational tool on primary coronary prevention: the Atherosclerosis Assessment Via Total Risk (AVIATOR) study
ABSTRACT Objective : The use of Framingham equations to determine 10-year absolute coronary risk ( “ global risk ” ) represents an accepted strategy to target coronary prevention measures and enhance clinical outcomes . The aim of this study was to determine the effects of providing global risk scores to physicians on the prescription of lipid-lowering therapy for patients at increased coronary risk . Research design and methods : This prospect i ve , r and omized controlled trial enrolled 368 primary -care patients without a history of coronary heart disease and not on therapy with a hydroxymethylglutaryl coenzyme A reductase inhibitor ( i.e. statin ) .  The study was conducted in the general medical clinics of an academic US teaching hospital . In the intervention group ( n = 186 ) patients ’ charts were review ed , 10‐year absolute coronary risk computed , and this information conveyed via a simple educational tool appended to charts . In the control group ( n = 182 ) , charts were accompanied by a form with general information on coronary prevention goals and strategies . Main outcome measure : The primary endpoint was the proportion of high-risk patients receiving a new statin prescription . Secondary and tertiary endpoints included ( 1 ) the proportion of moderate-risk patients receiving a statin prescription ; and ( 2 ) the proportion of patients in the whole cohort who had other coronary prevention measures recommended . Results : There was no significant difference in statin prescription to high-risk individuals in the intervention group ( 40.0 % ) compared with the control group ( 37.9 % ; p = 0.86 ) . Moderate-risk individuals who were not eligible for treatment according to the National Cholesterol Education Program Adult Treatment Panel II guidelines were more likely to receive a statin prescription in the intervention group versus the control group ( 28.8 % vs. 12.5 % . p = 0.036 ) Conclusions : Although a simple global risk educational tool did not improve the targeting of statin therapy to patients at high absolute coronary risk , it may be of benefit in targeting moderate-risk individuals who do not have markedly elevated low-density lipoprotein cholesterol ( LDL‐C ) levels . Future research should evaluate the effects of physicians performing their own Framingham risk calculations on statin prescribing and on cholesterol goal attainment
Limited data suggest that systematic risk assessment for CVD has no statistically significant effects on clinical endpoints .
There is limited evidence to suggest that CVD systematic risk assessment may have some favourable effects on cardiovascular risk factors .
BACKGROUND Screening programmes can potentially identify people at high cardiovascular risk and reduce cardiovascular disease ( CVD ) morbidity and mortality .
However , there is currently not enough evidence showing clear clinical or economic benefits of systematic screening-like programmes over the widely practised opportunistic risk assessment of CVD in primary care setting s. OBJECTIVES The primary objective of this review was to assess the effectiveness , costs and adverse effects of systematic risk assessment compared to opportunistic risk assessment for the primary prevention of CVD .