Recommendations Of The Project Group On Prevention Of The German Cardiac Society On Risk-Adjusted Prevention Of Cardiovascular Disease . Part 1: Risk Stratification And Implementation Of Prevention

Primary prevention of coronary artery disease (CAD) is becoming increasingly important because of the treatment costs of CAD. The assessment of overall cardiovascular risk is of importance to evaluate the effectiveness of medical therapy. Risk stratification in Germany is usually performed using the PROCAM algorithm or the ESC score. If the 10-year risk of myocardial infarction (PROCAM) or cardiovascular death (ESC SCORE) exceeds 20 or 5%, respectively, intensive risk intervention including medical therapy is cost-effective and the number needed to treat (NNT) is usually <200. An NNT of <200 can also be achieved by treating a single pronounced risk factor. The CARRISMA system uses lifestyle factors in addition to conventional factors to improve risk stratification and also supports lifestyle modification. During the last two decades average life expectancy has increased by 6 years and possibilities for prevention have improved. Risk stratification for prevention should therefore be offered up to the age of 70. Risk scores support evidence-based and cost-effective prevention.