Key result
ASCVD risk assessment in chronic respiratory diseases lacks standardized approaches across 68 identified methods.
Why the study?
Chronic respiratory diseases increase the risk of ASCVD, but systematic information on how existing methods to assess ASCVD risk may be applied to these populations is limited.
Systematic Review
Multiple ASCVD risk assessment methods exist for patients with chronic respiratory diseases, but there is a critical need for validated, tailored approaches to improve personalized risk stratification.
Variability in ASCVD risk tools for chronic respiratory diseases warrants cautious clinical use; leaves open need for validated, standardized approaches.
BACKGROUND: Chronic respiratory diseases, such COPD and asthma, increase the risk of atherosclerotic cardiovascular disease (ASCVD) through shared pathophysiological mechanisms and modifiable risk factors. There are a number of methods to assess ASCVD, and limited systematic information about how these may be applied to chronic respiratory diseases. OBJECTIVE: To systematically report existing methods of estimating ASCVD risk in chronic respiratory disease populations, highlighting strengths, limitations and clinical applicability. METHODS: A systematic search of MEDLINE, Embase, Scopus, and CINAHL was conducted up to June 2025 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (www.crd.york.ac.uk/PROSPERO identifier CRD42024543335). An extended search was also performed. To assess search sensitivity, a random sample of 30 studies from the extended search were reviewed. Key international clinical guidelines were examined for recommended tools. Studies assessing ASCVD risk in chronic respiratory disease populations were included. A narrative synthesis was employed. RESULTS: 63 studies from 26 countries identified 68 ASCVD risk assessment tools and biomarkers in chronic respiratory disease. Imaging techniques such as coronary artery calcium scoring, and carotid intima-media thickness provide detailed anatomical information, but require equipment and expertise. Risk scores (Framingham Risk Score; Systematic Coronary Risk Evaluation) are practical, although they lack precision at the individual level. Biomarkers and functional tests provide holistic measurements yet are often resource-demanding. Arterial stiffness measurement directly assesses vascular pathology and requires specialist equipment. CONCLUSION: Multiple ASCVD risk assessment methods exist for chronic respiratory diseases, highlighting the need to understand the strengths and weaknesses of tools for tailored solutions. Future studies should address validation, accessibility and improved personalised risk stratification.
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Uysal et al. (2025) conducted a systematic review in Chronic respiratory diseases. Atherosclerotic cardiovascular risk assessment methods was evaluated on Identification and description of ASCVD risk assessment methods. A systematic review of 63 studies identified 68 different atherosclerotic cardiovascular risk assessment methods used in chronic respiratory diseases, highlighting a lack of standardized, validated approaches.
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