[The risk of suffering a cardiovascular disease in the making of decisions. From evidence to the clinic].
The importance of the atherosclerotic cardiovascular disease (which is multifactorial in its origin) in Spain and the need for and efficient management of the treatments make especially useful to consider the overall cardiovascular risk of the individual in order to take clinical decisions towards the follow-up and treatment of the disease. Current evidence from cardiovascular risk situations supports this strategy of considering all the risk factors as a whole instead of evaluating each of them separately. This paper tries to revalidate this approach with the most reliable of the available evidence from case studies. The global cardiovascular risk is suggested to be evaluated by a risk chart based on Framingham's study. A revision of the clinical priorities in cardiovascular disease prevention is made. Finally, some views on ordinary clinical cases are given, suggesting the treatment based on a global risk evaluation, considering and opposing evidence and recommended guidelines from the most common Spanish guides on prevention of cardiovascular diseases, evaluating the potential benefit of treatment for the patient, and making a clinical decision.
Villar Alvarez
F
F
Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid. fvillar@msc.es
Maiques Galán
A
A
Franch Taix
M
M
Banegas Banegas
J R
JR
Vilaseca Canals
J
J
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain