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July 17, 2018

USPSTF Recommendations for Assessment of Cardiovascular Risk With Nontraditional Risk Factors: Finding the Right Tests for the Right Patients

Author Affiliations
  • 1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2018;320(3):242-244. doi:10.1001/jama.2018.9346

Cardiovascular disease (CVD) remains the leading cause of death in the United States and a major source of morbidity.1 Individuals in the United States have a 1 in 3 chance of dying from CVD and a 2 in 3 chance of developing CVD before death.2 However, control of risk factors, such as with cholesterol-lowering statin medications, can substantially reduce the likelihood of mortality and morbidity among at-risk patients. Identifying individuals who will benefit from this highly efficacious class of medications has been a priority of CVD prevention. For the purposes of primary prevention, the estimation of absolute risk of developing a CVD event is used to assist clinicians in determining which patients are likely to benefit from statin therapy,3 because net benefit (well in excess of any potential harms) is clearly seen in patients with estimated absolute risk of 7.5% or greater over 10 years.4 Estimation of absolute risk is practical, because it can be performed rapidly in clinical practice with the use of clinical calculators. Furthermore, quantitative risk estimation allows for a direct comparison of the risks and benefits of statin therapy so clinicians and patients can make informed decisions about therapy.

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