Risk Prediction in Cardiovascular Medicine Cardiovascular Risk Prediction

Few topics have received as much attention in the cardiovascular literature over the last 5 years as risk prediction. The assessment of risk has been a key element in efforts to define risk factors for cardiovascular disease (CVD), to identify novel markers of risk for CVD, to identify and assess potential targets of therapy, and to enhance the cost-effective implementation of therapies for both primary and secondary prevention of CVD. With the publication of the Third Report of the National Cholesterol Education Program’s Adult Treatment Panel (ATP-III)1 in 2001 and similar guidelines from other national and international bodies,2–5 risk prediction assumed a central role in the field of CVD prevention. Since then, numerous attempts have been made to refine and improve risk assessment methods. A basic review of the history and principles of risk prediction, their statistical underpinnings, and their clinical implications is thus required to help clinicians and researchers understand the increasingly complex approaches being undertaken to refine CVD risk prediction. Other articles in this series address the current adoption, utility, and effect of risk estimation algorithms in clinical prevention practice.