Studying Cardiovascular Risk More Precisely via Markers of Subclinical Atherosclerosis in the Heart SCORE Cohort

Abstract Current practice guidelines in primary prevention of cardiovascular disease (CVD) encourage risk-reducing strategies which founded based upon the individuals’ global cardiovascular risk, such as Framingham Risk Score (FRS). However, the currently used tools are imprecise as they misestimate the risk of the future CVD events. To deal with this problem, the markers of subclinical atherosclerosis were recommended as complements of the risk estimators. As these markers may behave differently in subgroups of race and risk, we hypothesized that studying these markers in these subgroups may give more precise insight on their improvement upon FRS in prediction of cardiovascular events. Our results on studying coronary artery calcification, carotid intima media thickness, and ankle brachial index in the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) cohort, have showed that subgrouping revealed hidden prediction improvement of these markers in subgroups of race and CVD risk.