Table of Contents
ISRN Cardiology
Volume 2011, Article ID 242656, 5 pages
http://dx.doi.org/10.5402/2011/242656
Review Article

Estimation of Absolute Cardiovascular Risk in Individuals with Diabetes Mellitus: Rationale and Approaches

1Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
2Division of Cardiology, Emory University School of Medicine, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA
3South African Medical Research Council and University of Cape Town, P.O. Box 19070, Tygerberg, Cape Town 7505, South Africa
4Julius Centre for Primary Care, University Medical Centre, Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands
5The George Institute for Global Health, The University of Sydney, P.O. Box M201, Sydney, Australia

Received 10 September 2011; Accepted 13 October 2011

Academic Editor: A. Dobrina

Copyright © 2011 Justin B. Echouffo-Tcheugui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To examine the usefulness of cardiovascular risk estimation models in people with diabetes. Methods. Review of published studies that compare the discriminative power of major cardiovascular risk factors single or in combination in individuals with and without diabetes, for major cardiovascular outcomes. Results. In individuals with and without diabetes, major risk factors affect cardiovascular risk similarly, with no evidence of any significant interaction. Accounting for diabetes-specific parameters, cardiopreventative therapies can significantly improve risk estimation in diabetes. General and diabetes-specific cardiovascular risk models have a useful discriminative power, but tend to overestimate risk in individuals with diabetes. Their impact on care delivery, adherence to therapies, and patients' outcome remain poorly understood. Conclusions. The high-risk status conferred by diabetes does not preclude the estimation of absolute cardiovascular risk estimation using global risk tools in individuals with diabetes, as this is useful for the initiation and intensification of preventive measures.