Risk estimation for the primary prevention of cardiovascular disease: considerations for appropriate risk prediction model selection

Kim Robin van Daalen; Dudan Zhang; Stephen Kaptoge; Ellie Paige; Emanuele Di Angelantonio; Lisa Pennells

doi:10.1016/S2214-109X(24)00210-9

Risk estimation for the primary prevention of cardiovascular disease: considerations for appropriate risk prediction model selection

Lancet Glob Health. 2024 Aug;12(8):e1343-e1358. doi: 10.1016/S2214-109X(24)00210-9.

Authors

Kim Robin van Daalen¹, Dudan Zhang¹, Stephen Kaptoge¹, Ellie Paige², Emanuele Di Angelantonio³, Lisa Pennells⁴

Affiliations

¹ British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
² Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Public Health, University of Queensland, Brisbane, QLD, Australia; Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
³ British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK; Health Data Science Research Centre, Human Technopole, Milan, Italy.
⁴ British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK. Electronic address: [email protected].

Abstract

Cardiovascular diseases remain the number one cause of death globally. Cardiovascular disease risk scores are an integral tool in primary prevention, being used to identify individuals at the highest risk and guide the assignment of preventive interventions. Available risk scores differ substantially in terms of the population sample data sources used for their derivation and, consequently, in the absolute risks they assign to individuals. Differences in cardiovascular disease epidemiology between the populations contributing to the development of risk scores, and the target populations in which they are applied, can result in overestimation or underestimation of cardiovascular disease risks for individuals, and poorly informed clinical decisions. Given the wide plethora of cardiovascular disease risk scores available, identification of an appropriate risk score for a target population can be challenging. This Review provides an up-to-date overview of guideline-recommended cardiovascular disease risk scores from global, regional, and national contexts, evaluates their comparative characteristics and qualities, and provides guidance on selection of an appropriate risk score.

Publication types

Review

MeSH terms

Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / prevention & control
Heart Disease Risk Factors
Humans
Primary Prevention*
Risk Assessment / methods