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.
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.
Lancet Glob Health. 2024 Aug;12(8):e1343-e1358. doi: 10.1016/S2214-109X(24)00210-9.
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.
心血管疾病仍然是全球头号死因。心血管疾病风险评分是初级预防的重要工具，用于识别风险最高的个体，并指导预防干预措施的分配。现有的风险评分在用于推导的人群样本数据来源方面存在很大差异，因此，它们为个体分配的绝对风险也不同。导致风险评分发展的人群与应用风险评分的目标人群之间心血管疾病流行病学的差异，可能导致个体心血管疾病风险的高估或低估，以及临床决策信息不足。鉴于现有的心血管疾病风险评分种类繁多，为目标人群确定合适的风险评分可能具有挑战性。这篇综述提供了全球、区域和国家背景下指南推荐的心血管疾病风险评分的最新概述，评估了它们的比较特征和质量，并就选择合适的风险评分提供了指导。
