Risk assessment for ischaemic heart disease

Abstract

Coronary heart disease (CHD) poses a special challenge for risk assessment. Various kinds of diagnostic or therapeutic procedures, concomitant diseases, risk factors and symptoms need to be connected logically in order to assess the risk of each individual patient. Clinical evaluation of cardiovascular risk in patients with hypertension is evolving from independently assessing well-known, traditional risk factors (e.g. hypertension, hypercholesterolemia, obesity, diabetes mellitus, smoking) towards an integrated, multidisciplinary clinical approach, aimed at determining the global (or total) cardiovascular risk profile in each individual patient for planning early and effective strategies for prevention. The Framingham risk score provides a pragmatic basis for assessing the global 10-year CHD risk in this population. However, the Framingham risk score needs to be supplemented with additional information to truly identify the patients at risk. The role of emerging risk factors remains unresolved as is the value of attempting to routinely diagnose subclinical disease with measurements such as the coronary calcium score. In this review, we discuss the potentially modifiable risk factors, various risk prediction models and strategies proposed to reduce the cardiovascular disease burden in India.

Keywords

• chd
• ischaemic heart disease
• cardiovascular disease
• metabolic syndrome