Cardiovascular Risk Assessment: A Systematic Review of Guidelines.
BACKGROUND
Many guidelines exist for screening and risk assessment for the primary prevention of cardiovascular disease in apparently healthy persons.


OBJECTIVE
To systematically review current primary prevention guidelines on adult cardiovascular risk assessment and highlight the similarities and differences to aid clinician decision making.


METHODS
Publications in MEDLINE and CINAHL between 3 May 2009 and 30 June 2016 were identified. On 30 June 2016, the Guidelines International Network International Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and Web sites of organizations responsible for guideline development were searched.


METHODS
2 reviewers screened titles and abstracts to identify guidelines from Western countries containing recommendations for cardiovascular risk assessment for healthy adults.


METHODS
2 reviewers independently assessed rigor of guideline development using the Appraisal of Guidelines for Research and Evaluation II instrument, and 1 extracted the recommendations.


RESULTS
Of the 21 guidelines, 17 showed considerable rigor of development. These recommendations address assessment of total cardiovascular risk (5 guidelines), dysglycemia (7 guidelines), dyslipidemia (2 guidelines), and hypertension (3 guidelines). All but 1 recommendation advocates for screening, and most include prediction models integrating several relatively simple risk factors for either deciding on further screening or guiding subsequent management. No consensus on the strategy for screening, recommended target population, screening tests, or treatment thresholds exists.


CONCLUSIONS
Only guidelines developed by Western national or international medical organizations were included.


CONCLUSIONS
Considerable discrepancies in cardiovascular screening guidelines still exist, with no consensus on optimum screening strategies or treatment threshold.


BACKGROUND
Barts Charity.
From Queen Mary University of London, London, United Kingdom; Federal University of Juiz de Fora School of Medicine, Juiz de Fora, Minas Gerais, Brazil; Erasmus Medical Center, Rotterdam, the Netherlands; and Icahn School of Medicine at Mount Sinai, New York, New York.
Mohammed Y
MY
Khanji
From Queen Mary University of London, London, United Kingdom; Federal University of Juiz de Fora School of Medicine, Juiz de Fora, Minas Gerais, Brazil; Erasmus Medical Center, Rotterdam, the Netherlands; and Icahn School of Medicine at Mount Sinai, New York, New York.
Vinícius V S
VV
Bicalho
From Queen Mary University of London, London, United Kingdom; Federal University of Juiz de Fora School of Medicine, Juiz de Fora, Minas Gerais, Brazil; Erasmus Medical Center, Rotterdam, the Netherlands; and Icahn School of Medicine at Mount Sinai, New York, New York.
Claudia N
CN
van Waardhuizen
From Queen Mary University of London, London, United Kingdom; Federal University of Juiz de Fora School of Medicine, Juiz de Fora, Minas Gerais, Brazil; Erasmus Medical Center, Rotterdam, the Netherlands; and Icahn School of Medicine at Mount Sinai, New York, New York.
Bart S
BS
Ferket
From Queen Mary University of London, London, United Kingdom; Federal University of Juiz de Fora School of Medicine, Juiz de Fora, Minas Gerais, Brazil; Erasmus Medical Center, Rotterdam, the Netherlands; and Icahn School of Medicine at Mount Sinai, New York, New York.
Steffen E
SE
Petersen
From Queen Mary University of London, London, United Kingdom; Federal University of Juiz de Fora School of Medicine, Juiz de Fora, Minas Gerais, Brazil; Erasmus Medical Center, Rotterdam, the Netherlands; and Icahn School of Medicine at Mount Sinai, New York, New York.
M G Myriam
MG
Hunink
D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000517:prevention & control*; D000066491:Clinical Decision-Making; D050171:Dyslipidemias / Q000175:diagnosis / Q000517:prevention & control; D044882:Glucose Metabolism Disorders / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D018570:Risk Assessment