Updating the VIVOPTIM Program for the Assessment of Cardiovascular Risk

Figures & data

Box 1 Main Limitations to an Initial Cardiovascular Risk Assessment Based on the Framingham Equation

Few young participants in the highest cardiovascular risk group.

Young participants with several modifiable cardiovascular risk factors often ranked at low or moderate risk.

No specific rules for evaluation of risk in individuals on drug therapy (eg, for diabetes, hypertension, or dyslipidemia) and/or already in secondary prevention.

Neither duration nor quantification of risk factors taken into consideration.

Because family history of early-onset cardiovascular disease, chronic stress, overweight, diet, and sedentary lifestyle were disregarded, participants felt the assessment was incomplete and did not consider them on an individual basis.

It is demoralizing for people who go to great efforts of prevention to learn they are at high cardiovascular risk.

It is counterproductive to tell someone with several behavioral risk factors for cardiovascular disease—such as smoking, sedentary lifestyle, or overweight—that their cardiovascular risk is low.

Table 1 Parameters Used in the Updated Version of the Cardiovascular Risk Assessment

Major Cardiovascular Risk Factors	Associated Cardiovascular Risk Factors (with a 0.5 Weighting)
Non modifiable (or difficult to modify) risk factors
-Age (>50 M, >60 F)	-Kidney disease
-Family history of early-onset cardiovascular disease (<55M, <65F)	-Chronic inflammatory disease -Social vulnerability
Potentially modifiable risk factors
-Current smoking (or quit for <3 years)	-Sedentary lifestyle
-Atherogenic dyslipidemia	-Chronic stress
-Hypertension	-Obesity
-Diabetes mellitus	-non-Mediterranean diet

Notes: Low cardiovascular risk: 0 or 1 cardiovascular risk factor, moderate cardiovascular risk: 2 or 3 cardiovascular risk factors, high cardiovascular risk: ≥4 cardiovascular risk factors or already in a context of secondary cardiovascular prevention. No excess risk: no modifiable cardiovascular risk factor, noteworthy excess risk: 1 modifiable cardiovascular risk factor, moderate excess risk: 2 modifiable cardiovascular risk factors, severe excess risk: ≥3 modifiable cardiovascular risk factors.

Abbreviations: M, male; F, female.