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Despite significant advances in prevention and treatment, cardiovascular disease (CVD) remains a significant cause of mortality and morbidity. CVD is the most common cause of death worldwide, and its burden is increasing.1 In the UK it accounts for a quarter of all deaths.2 Given the morbidity associated with CVD, identification of individuals at high risk is particularly important.
Currently clinical risk scores such as the QRISK assessment tool3 are recommended for evaluating CVD risk.4 5 Tools such as these use a combination of clinical variables, risk factors and laboratory tests to calculate an individual’s CVD risk over a period of time (typically 10 years). If the calculated level of risk is above a set threshold then preventative therapy such as statins are recommended. These risk scores are widely validated and tend to perform well, with a Harrel’s C-statistic of ~0.8, although the C-statistic is sometimes lower in studies using other populations to those from which the scores were derived.6 It is accepted that these tools are unfortunately not perfect, and there will be individuals who are assigned a low or intermediate clinical risk and therefore not started on preventative therapy who still have CVD.7
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Contributors IM and MT conceived this editorial and drafted and revised the content. Both authors have agreed on the final manuscript for publication. IM is responsible for the overall content as guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.