Cardiovascular risk scales

The prevention of cardiovascular diseases is based on the individual risk evaluation. Taking into account the totality of the risk factors, and the individual characteristics of patients, permit a correct assessment of the global cardiovascular risk score. Some cardiovascular risk scales were created with the aim of helping the physician in his clinical practice.The first Framingham risk equation collects the most important risk factors: age, gender, systolic (or diastolic) blood pressure, total cholesterol/HDL-cholesterol, smoking, diabetes, electric left ventricular hypertrophy as determined by the Sokolow index. Nonetheless, this risk scale presents several limitations on the estimation of the risk level. In particular, the application of the scale only for the primary prevention, the inaccuracy of the clinic measurement of risk factors, the absence of long term information on young patients without risk factors, the impossibility of identifying the score level from which it is proposed to start or change a treatment.In the last years the discovery of new cardiovascular risk factors gave the hope to better evaluate the global cardiovascular risk, but currently there are no convincing studies proving their added value in risk prevention.Aware of all these limitations, the French recommendations suggested assessing the global risk by means of the total number of risk factors instead of applying a risk scale.Finally, many concerns have to be solved before a large, consensual and effective application of these risk models in the clinical practice. © 2011-Elsevier Masson SAS-Tous droits réservés.