How to conduct a risk assessment of cardiovascular disease

How to conduct a risk assessment of cardiovascular disease?

How to conduct a risk assessment of cardiovascular disease

For all asymptomatic adults, when assessing cardiovascular risk:

1. The overall risk assessment method recommended by this consensus should be used according to traditional cardiovascular risk factors (including age, gender, overweight and obesity, smoking, blood pressure, total cholesterol levels, and diabetes). Evaluation.

2. According to the overall risk score, the subjects can be divided into: low risk (10-year risk of ischemic cardiovascular disease <10%), moderate risk (ischemic cardiovascular disease 10 years of risk 10) %-20%) and high risk (10-year risk of ischemic cardiovascular disease >20%).

3. The family history of cardiovascular disease, especially coronary heart disease and stroke, should be detailed.

4. Glycated hemoglobin (HbA1C) can be detected if necessary.

5. If necessary, a resting 12-lead ECG can be performed.

For asymptomatic adults with low to moderate risk (6% to 10% risk of ischemic cardiovascular disease), assess cardiovascular risk: if necessary, use computed tomography (CT) for coronary Arterial calcification (CAC) measurements.



For asymptomatic adults with moderate risk, when assessing cardiovascular risk:

1. ≤ 50 years old males or ≤ 60 years old females, if necessary, can be tested for C-reactive protein (CRP) levels.

2. People without hypertension or diabetes can detect microalbuminuria (MAU) if necessary.

3. If necessary, exercise ECG can be performed.

4. The carotid intima-media thickness (IMT) should be measured using ultrasound techniques.

5. ABI testing should be performed.

6. Coronary artery calcification (CAC) measurements can be performed using CT techniques.

For asymptomatic adults with diabetes or a family history of coronary heart disease, or a previous risk assessment that clearly indicates a high risk of coronary heart disease (eg coronary artery calcification CAC score ≥ 400), when assessing cardiovascular risk: load nuclides may be used Myocardial perfusion imaging (MPI) is a higher-level examination of cardiovascular risk assessment.

Other cases: 

1. For cardiovascular risk assessment in asymptomatic adults, C-reactive protein (CRP) levels are measured in populations meeting all of the following conditions:

• Low-density lipoprotein cholesterol (LDL-C) is lower than 130 mg/dL (3.36 mmol/L) in men aged 1 ≥ 50 years or women ≥ 60 years old;
• Did not receive lipid-lowering, hormone replacement or immunosuppressive therapy;
• No diabetes, chronic kidney disease or serious infection.

2. For asymptomatic adults with hypertension or diabetes, MAU should be tested when assessing cardiovascular risk.

3. For asymptomatic adults with high blood pressure, plasma homocysteine ​​(HCY) levels should be tested when assessing cardiovascular risk.

4. For asymptomatic adults with diabetes (without high blood pressure), when assessing cardiovascular risk, plasma homocysteine ​​(HCY) levels can be tested if necessary.

5. For asymptomatic adults with hypertension or diabetes, a resting 12-lead ECG should be routinely performed when assessing cardiovascular risk.

6. For asymptomatic adults with high blood pressure, echocardiography can be used to detect left ventricular hypertrophy when assessing cardiovascular risk.

7. For asymptomatic adults with multiple risk factors such as hypertension or diabetes, peripheral arterial blood flow-mediated vasodilation (FMD) can be performed if necessary to assess cardiovascular risk.