Zuin Marco, Bilato Claudio, Temporelli Pier Luigi
Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Padua, Italy.
Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy.
High Blood Press Cardiovasc Prev. 2025 Jun 9. doi: 10.1007/s40292-025-00724-x.
Cardiovascular diseases (CVDs) remain the leading cause of death and disability worldwide. Over the last two decades, different risk score models, generally assessing the short-term (10-year) risk estimates, have been developed to predict risk and to provide guidance for informed decision-making regarding initiation or intensification of CVD prevention strategies. However, the short-term risk estimation of CVD mortality/morbidity deeply underestimates the lifetime CVD risk, especially in younger age individuals and in women. Moreover, the greatest number of CV events occurs in subjects with low/moderate short-term risk because they are prevalent in the general population. By contrast, estimates of the lifetime risk of CVD may provide a more comprehensive assessment by considering both traditional and non-traditional CV risk factors as well as the potential competing risks, which leads to a more accurate and tailored assessment of the patient's health status. Aim of the present manuscript is to review the latest proposed strategies regarding the estimation of lifetime CV risk and how these strategies may be helpful in daily clinical practice both in primary and secondary prevention.
心血管疾病(CVDs)仍然是全球范围内导致死亡和残疾的主要原因。在过去二十年中,已经开发出了不同的风险评分模型,这些模型通常用于评估短期(10年)风险估计,以预测风险,并为关于启动或强化心血管疾病预防策略的明智决策提供指导。然而,心血管疾病死亡率/发病率的短期风险估计严重低估了终生心血管疾病风险,尤其是在年轻个体和女性中。此外,最大数量的心血管事件发生在短期风险低/中度的人群中,因为他们在普通人群中很普遍。相比之下,心血管疾病终生风险的估计可以通过考虑传统和非传统心血管风险因素以及潜在的竞争风险,提供更全面的评估,从而对患者的健康状况进行更准确和个性化的评估。本手稿的目的是回顾关于终生心血管风险估计的最新提出的策略,以及这些策略如何在初级和二级预防的日常临床实践中发挥作用。