Vascular Risk Calculators

A recent individual participant meta-analysis of statin tri- als 1 has established beyond reasonable doubt that a patient's pretreatment vascular risk is the most important, easily measureable determinant of the effectiveness of statins.In this meta-analysis, the calculated baseline vascular risk was a much better predictor of absolute treatment benefit than the degree of low-density lipoprotein cholesterol (LDL-C) lowering (Figure ), and the relative benefits of lipid lowering were largely independent of baseline low-density lipoprotein levels.Numerous studies have already demonstrated that a calculated risk is a much better predictor of future vascular events than LDL-C levels alone, or indeed any other single cardiovascular disease (CVD) risk factor.[2][3][4] Therefore, many patients with average LDL-C levels but high calculated vascular risk will benefit significantly more from statins than patients at low vascular risk but with higher LDL-C levels.A similar individual participant meta-analysis of trials of blood pressure-lowering drugs is currently underway, and the preliminary findings are consistent with the statin results (Johan Sundstrom, MD, PhD, unpublished data, 2013).