How should cardiovascular risk be estimated to guide antihypertensive treatment?
Absolute cardiovascular risk assessment, preferably using Framingham-based methods, is essential for determining the appropriate use of antihypertensive therapy.
c The absolute risk of cardiovascular disease dictates the absolute benefit from antihypertensive treatment. Absolute risk assessment is essential to ensure high risk patients are treated while avoiding treatment of low risk patients c In certain patients formal risk assessment is unnecessary because certain risk factors always place patients at high risk c Where formal risk assessment is necessary, methods based on the Framingham risk function are preferable and a number of computer programs and simple paper based risk assessment methods are available c CHD risk multiplied by 4/3 is an acceptable surrogate for CVD risk. c Additional refinements in risk factor measurement such as ambulatory blood pressure measurement or echocardiography usually add little information to formal risk estimates c The threshold of CVD risk at which treatment is justified is a matter for continued research and debate
E. J Wallis (Sun,) studied this question.