Risk-Oriented Strategy as the Way to Improve the Effectiveness of Cardiovascular Prevention and the Rational Use of Primary Healthcare Resources

Introduction. Over the past decades, cardiovascular diseases have become an even bigger threat to human health. The effect they have on human life in large cities is evident. Efficient prevention of cardiovascular diseases requires the use of a risk-oriented strategy based on early detection of high-risk individuals at the primary care level.

The purpose of the study is to summarize modern innovative approaches to assessing cardiovascular risks and substantiating strategies for preventing atherosclerotic cardiovascular diseases (ASCVD).

Results. The list of reviewed risk assessment models included the following: PREVENT 2023, pooled cohort equations (PCE), SCORE2, SMART 2, EUROASPIRE, LIFE-CVD, and other scales. Modern ACC/AHA and ESC/EAS guidelines were highlighted with focus on selecting comprehensive ASCVD prevention strategies, which may encompass the use of statins. The role of instrumental assessment of coronary calcification and ultrasound imaging of carotid arteries was also discussed.

Conclusions. The use of risk calculators allows for timely decisions about initiating or intensifying therapy based on the expected clinical benefit. However, even the validated models based on large population datasets do not always assess the risk accurately, especially in atypical cases. Therefore, risk stratification should also incorporate additional (non-traditional) markers, such as subclinical atherosclerosis indicators, inflammation biomarkers, imaging data, and genetic predictors.

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