Predictive Value of Cardiovascular Risk Functions: Limitations and Future Potential

Cardiovascular risk functions are useful tools that can be applied in the initial screening of patients with cardiovascular disease to identify priorities for primary prevention. The application of these tools must be based on prospective studies that have demonstrated their validity while also taking into account the limitations inherent in their sensitivity and positive predictive value. Their precision and reliability could be improved by incorporating new markers with good predictive abilities that are also, in order of priority, easy and inexpensive to measure and readily accessible, such as waist circumference, renal function and drug usage. At some point in the relatively near future, genetic factors could also have a useful role to play. Newer versions of the risk functions encapsulate a more comprehensive view of cardiovascular risk and, with computerization, will become more versatile and easier to use. In the very near future, the process of estimating cardiovascular risk using risk functions will change as it becomes possible to substitute one variable for another, as new versions based on age and life-expectancy are developed, and as patients share greater responsibility for their own health.