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Meta-Analysis
. 2017 Mar 14;3(3):CD006887.
doi: 10.1002/14651858.CD006887.pub4.

Risk scoring for the primary prevention of cardiovascular disease

Kunal N Karmali  1 , Stephen D Persell  2 , Pablo Perel  3 , Donald M Lloyd-Jones  4 , Mark A Berendsen  5 , Mark D Huffman  4
Affiliations
Meta-Analysis

Risk scoring for the primary prevention of cardiovascular disease

Kunal N Karmali et al. Cochrane Database Syst Rev. .

Abstract

Background: The current paradigm for cardiovascular disease (CVD) emphasises absolute risk assessment to guide treatment decisions in primary prevention. Although the derivation and validation of multivariable risk assessment tools, or CVD risk scores, have attracted considerable attention, their effect on clinical outcomes is uncertain.

Objectives: To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (2016, Issue 2), MEDLINE Ovid (1946 to March week 1 2016), Embase (embase.com) (1974 to 15 March 2016), and Conference Proceedings Citation Index-Science (CPCI-S) (1990 to 15 March 2016). We imposed no language restrictions. We searched clinical trial registers in March 2016 and handsearched reference lists of primary studies to identify additional reports.

Selection criteria: We included randomised and quasi-randomised trials comparing the systematic provision of CVD risk scores by a clinician, healthcare professional, or healthcare system compared with usual care (i.e. no systematic provision of CVD risk scores) in adults without CVD.

Data collection and analysis: Three review authors independently selected studies, extracted data, and evaluated study quality. We used the Cochrane 'Risk of bias' tool to assess study limitations. The primary outcomes were: CVD events, change in CVD risk factor levels (total cholesterol, systolic blood pressure, and multivariable CVD risk), and adverse events. Secondary outcomes included: lipid-lowering and antihypertensive medication prescribing in higher-risk people. We calculated risk ratios (RR) for dichotomous data and mean differences (MD) or standardised mean differences (SMD) for continuous data using 95% confidence intervals. We used a fixed-effects model when heterogeneity (I²) was at least 50% and a random-effects model for substantial heterogeneity (I² > 50%). We evaluated the quality of evidence using the GRADE framework.

Main results: We identified 41 randomised controlled trials (RCTs) involving 194,035 participants from 6422 reports. We assessed studies as having high or unclear risk of bias across multiple domains. Low-quality evidence evidence suggests that providing CVD risk scores may have little or no effect on CVD events compared with usual care (5.4% versus 5.3%; RR 1.01, 95% confidence interval (CI) 0.95 to 1.08; I² = 25%; 3 trials, N = 99,070). Providing CVD risk scores may reduce CVD risk factor levels by a small amount compared with usual care. Providing CVD risk scores reduced total cholesterol (MD -0.10 mmol/L, 95% CI -0.20 to 0.00; I² = 94%; 12 trials, N = 20,437, low-quality evidence), systolic blood pressure (MD -2.77 mmHg, 95% CI -4.16 to -1.38; I² = 93%; 16 trials, N = 32,954, low-quality evidence), and multivariable CVD risk (SMD -0.21, 95% CI -0.39 to -0.02; I² = 94%; 9 trials, N = 9549, low-quality evidence). Providing CVD risk scores may reduce adverse events compared with usual care, but results were imprecise (1.9% versus 2.7%; RR 0.72, 95% CI 0.49 to 1.04; I² = 0%; 4 trials, N = 4630, low-quality evidence). Compared with usual care, providing CVD risk scores may increase new or intensified lipid-lowering medications (15.7% versus 10.7%; RR 1.47, 95% CI 1.15 to 1.87; I² = 40%; 11 trials, N = 14,175, low-quality evidence) and increase new or increased antihypertensive medications (17.2% versus 11.4%; RR 1.51, 95% CI 1.08 to 2.11; I² = 53%; 8 trials, N = 13,255, low-quality evidence).

Authors' conclusions: There is uncertainty whether current strategies for providing CVD risk scores affect CVD events. Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher-risk people without evidence of harm. There were multiple study limitations in the identified studies and substantial heterogeneity in the interventions, outcomes, and analyses, so readers should interpret results with caution. New models for implementing and evaluating CVD risk scores in adequately powered studies are needed to define the role of applying CVD risk scores in primary CVD prevention.

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Conflict of interest statement

KNK ‐ none known. KNK received support from the National Heart, Lung, and Blood Institute training grant in cardiovascular epidemiology and prevention during the conduct of this work (T32 HL069771).

SDP ‐ author on 2 included studies*. SDP receives grant support from Pfizer, Inc. for research outside the submitted work.

PP ‐ none known.

DML‐J ‐ author on 2 included studies*.

MAB ‐ none known.

MDH ‐ MDH receives support from the World Heart Federation to serve as the senior programme advisor for its Emerging Leaders programme, which has been supported by Boehringer Ingelheim, Novartis, Bupa, and AstraZeneca. MDH is also a Cochrane Heart Group satellite coordinating editor and associate editor for JAMA for which he receives compensation from the American Medical Association. MDH also receives travel support from the American Heart Association.

*Note that data extraction and risk of bias assessment for these two trials were performed by authors not involved in the study (KNK and MDH).

Figures

1
1
Study flow diagram.
2
2
Summary of CVD risk score interventions by included study.
Abbreviations: CHD: coronary heart disease; CVD: cardiovascular disease; FRS: Framingham risk score; MI: myocardial infarction; RF: risk factors, RR: risk ratio; UKPDS: United Kingdom Prospective Diabetes Study
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
5
5
Funnel plot of comparison: 1 CVD risk score versus no CVD risk score/usual care, outcome: 1.3 Total cholesterol (mmol/L).
6
6
Funnel plot of comparison: 1 CVD risk score versus no CVD risk score/usual care, outcome: 1.5 Systolic blood pressure (mmHg).
7
7
Funnel plot of comparison: 1 CVD risk score versus no CVD risk score/usual care, outcome: 1.7 Change in multivariable CVD risk.
1.1
1.1. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 1: CVD events
1.2
1.2. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 2: CVD events, excluding Bucher 2010
1.3
1.3. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 3: Total cholesterol
1.4
1.4. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 4: Low‐density lipoprotein cholesterol
1.5
1.5. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 5: Systolic blood pressure
1.6
1.6. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 6: Diastolic blood pressure
1.7
1.7. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 7: Change in multivariable CVD risk
1.8
1.8. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 8: Adverse events (investigator defined)
1.9
1.9. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 9: Anxiety
1.10
1.10. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 10: New/intensified lipid‐lowering medication
1.11
1.11. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 11: New/intensified antihypertensive medication
1.12
1.12. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 12: New aspirin
1.13
1.13. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 13: Medication adherence
1.14
1.14. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 14: Smoking cessation
1.15
1.15. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 15: Exercise
1.16
1.16. Analysis
Comparison 1: CVD risk score versus no CVD risk score/usual care, Outcome 16: Decisional conflict
2.1
2.1. Analysis
Comparison 2: CVD risk score versus no CVD risk score/usual care by decision support use, Outcome 1: Total cholesterol by decision support use
2.2
2.2. Analysis
Comparison 2: CVD risk score versus no CVD risk score/usual care by decision support use, Outcome 2: Low‐density lipoprotein cholesterol by decision support
2.3
2.3. Analysis
Comparison 2: CVD risk score versus no CVD risk score/usual care by decision support use, Outcome 3: Systolic blood pressure by decision support use
2.4
2.4. Analysis
Comparison 2: CVD risk score versus no CVD risk score/usual care by decision support use, Outcome 4: Diastolic blood pressure by decision support use
2.5
2.5. Analysis
Comparison 2: CVD risk score versus no CVD risk score/usual care by decision support use, Outcome 5: Change in multivariable CVD risk by decision support
3.1
3.1. Analysis
Comparison 3: CVD risk score versus no CVD risk score/usual care by health IT use, Outcome 1: Total cholesterol by health IT use
3.2
3.2. Analysis
Comparison 3: CVD risk score versus no CVD risk score/usual care by health IT use, Outcome 2: Low‐density lipoprotein cholesterol by health IT use
3.3
3.3. Analysis
Comparison 3: CVD risk score versus no CVD risk score/usual care by health IT use, Outcome 3: Systolic blood pressure by health IT use
3.4
3.4. Analysis
Comparison 3: CVD risk score versus no CVD risk score/usual care by health IT use, Outcome 4: Diastolic blood pressure by health IT use
3.5
3.5. Analysis
Comparison 3: CVD risk score versus no CVD risk score/usual care by health IT use, Outcome 5: Change in multivariable CVD risk by health IT use
4.1
4.1. Analysis
Comparison 4: CVD risk score versus no CVD risk score/usual care by risk status of participants, Outcome 1: Total cholesterol by risk status
4.2
4.2. Analysis
Comparison 4: CVD risk score versus no CVD risk score/usual care by risk status of participants, Outcome 2: Low‐density lipoprotein cholesterol by risk status
4.3
4.3. Analysis
Comparison 4: CVD risk score versus no CVD risk score/usual care by risk status of participants, Outcome 3: Systolic blood pressure by risk status
4.4
4.4. Analysis
Comparison 4: CVD risk score versus no CVD risk score/usual care by risk status of participants, Outcome 4: Diastolic blood pressure by risk status
4.5
4.5. Analysis
Comparison 4: CVD risk score versus no CVD risk score/usual care by risk status of participants, Outcome 5: Change in multivariable CVD risk by risk status
5.1
5.1. Analysis
Comparison 5: Multivariable CVD risk, Outcome 1: Multivariable CVD risk
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References

References to studies included in this review

Benner 2008 {published data only}
    1. Benner JS, Cherry SB, Erhardt L, Fernandes M, Flammer M, Gaciong Z, et al. Rationale, design, and methods for the risk evaluation and communication health outcomes and utilization trial (REACH OUT). Contemporary Clinical Trials 2007;28:662-73. - PubMed
    1. Benner JS, Erhardt L, Flammer M, Moller RA, Rajicic N, Changela K, et al. A novel programme to evaluate and communicate 10-year risk of CHD reduces predicted risk and improves patients' modifiable risk factor profile. International Journal of Clinical Practice 2008;62:1484-98. - PMC - PubMed
Bertoni 2009 {published data only}
    1. Bertoni AG, Bonds DE, Chen H, Hogan P, Crago L, Rosenberger E, et al. Impact of a multifaceted intervention on cholesterol management in primary care practices: guideline adherence for heart health randomized trial. Archives of Internal Medicine 2009;169:678-86. - PMC - PubMed
British Family Heart 1994 {published data only}
    1. Family Heart Study Group. British family heart study: its design and method, and prevalence of cardiovascular risk factors. British Journal of General Practice 1994;44:62-7. - PMC - PubMed
    1. Family Heart Study Group. Randomised controlled trial evaluating cardiovascular screening and intervention in general practice: principal results of British family heart study. BMJ 1994;308:313-20. - PMC - PubMed
Bucher 2010 {published data only}
    1. Bucher HC, Rickenbach M, Young J, Glass TR, Vallet Y, Bernasconi E, et al. Randomized trial of a computerized coronary heart disease risk assessment tool in HIV-infected patients receiving combination antiretroviral therapy. Antiviral Therapy 2010;15(1):31-40. - PubMed
Christensen 2004 {published data only}
    1. Christensen B, Engberg M, Lauritzen T. No long-term psychological reaction to information about increased risk of coronary heart disease in general practice. European Journal of Cardiovascular Prevention and Rehabilitation 2004;11(3):239-43. - PubMed
Cobos 2005 {published data only}
    1. Cobos A, Vilaseca J, Asenjo C, Pedro-Botet J, Sanchez E, Val A, et al. Cost effectiveness of a clinical decision support system based on the recommendations of the European Society of Cardiology and other societies for the management of hypercholesterolemia: Report of a cluster-randomized trial. Disease Management and Health Outcomes 2005;13(6):421-32.
Denig 2014 {published data only}
    1. Denig P, Dun M, Schuling J, Haaijer-Ruskamp FM, Voorham J. The effect of a patient-oriented treatment decision aid for risk factor management in patients with diabetes (PORTDA-diab): study protocol for a randomised controlled trial. Trials 2012;13:219. - PMC - PubMed
    1. Denig P, Schuling J, Haaijer-Ruskamp F, Voorham J. Effects of a patient oriented decision aid for prioritising treatment goals in diabetes: pragmatic randomised controlled trial. BMJ 2014;349:g5651. - PubMed
Eaton 2011 {published and unpublished data}
    1. Eaton CB, Parker DR, Borkan J, McMurray J, Roberts MB, Lu B, et al. Translating cholesterol guidelines into primary care practice: a multimodal cluster randomized trial. Annals of Family Medicine 2011;9(6):528-37. - PMC - PubMed
Edelman 2006 {published data only}
    1. Edelman D, Oddone EZ, Liebowitz RS, Yancy WS Jr, Olsen MK, Jeffreys AS, et al. A multidimensional integrative medicine intervention to improve cardiovascular risk. Journal of General Internal Medicine 2006;21(7):728-34. - PMC - PubMed
Engberg 2002 {published data only}
    1. Engberg M, Christensen B, Karlsmose B, Lous J, Lauritzen T. Can systematic general health checks and health discussions improve the cardiovascular risk profile in the population?: A randomized and controlled study in general practice with five years follow-up [Kan systematiske generelle helbredsundersøgelser og helbredssamtaler forbedre den kardiovaskulaere risikoprofil i befolkningen?: En randomiseret og kontrolleret undersøgelse i almen praksis med fem års opfølgning]. Ugeskrift for Laeger 2002;164:3354-60. - PubMed
    1. Engberg M, Christensen B, Karlsmose B, Lous J, Lauritzen T. General health screenings to improve cardiovascular risk profiles: a randomized controlled trial in general practice with 5-year follow-up. Journal of Family Practice 2002;51:546-52. - PubMed
    1. Lauritzen T, Leboeuf-Yde C, Lunde IM, Nielsen KD. Ebeltoft project: baseline data from a five-year randomized, controlled, prospective health promotion study in a Danish population. British Journal of General Practice 1995;45:542-7. - PMC - PubMed
Grover 2007 {published data only}
    1. Grover SA, Lowensteyn I, Joseph L, Kaouache M, Marchand S, Coupal L, et al. Discussing coronary risk with patients to improve blood pressure treatment: secondary results from the CHECK-UP study. Journal of General Internal Medicine 2009;24:33-9. - PMC - PubMed
    1. Grover SA, Lowensteyn I, Joseph L, Kaouache M, Marchand S, Coupal L, et al. Patient knowledge of coronary risk profile improves the effectiveness of dyslipidemia therapy - The CHECK-UP study: a randomized controlled trial. Archives of Internal Medicine 2007;167:2296-303. - PubMed
Hall 2003 {published data only}
    1. Hall LM, Jung RT, Leese GP. Controlled trial of effect of documented cardiovascular risk scores on prescribing. BMJ 2003;326:251-2. - PMC - PubMed
Hanlon 1995 {published data only}
    1. Hanlon P, McEwen J, Carey L, Gilmour H, Tannahill C, Tannahill A, et al. Health checks and coronary risk: further evidence from a randomised controlled trial. BMJ 1995;311:1609-13. - PMC - PubMed
Hanon 2000 {published data only}
    1. Hanon O, Franconi G, Mourad JJ, Baleydier A, Croce I, Girerd X. The estimation of cardiovascular risk in hypertensive patients is not modified by management of the hypertension [L'estimation du risque cardiovasculaire chez des patients hypertendus ne modifie pas la prise en charge de l'HTA]. Archives des Maladies du Coeur et des Vaisseaux 2000;93(8):943-7. - PubMed
Hetlevik 1999 {published data only}
    1. Hetlevik I, Holmen J, Kruger O. Implementing clinical guidelines in the treatment of hypertension in general practice. Evaluation of patient outcome related to implementation of a computer-based clinical decision support system. Scandinavian Journal of Primary Health Care 1999;17:35-40. - PubMed
Holt 2010 {published data only}
    1. Holt TA, Thorogood M, Griffiths F, Munday S, Friede T, Stables D. Automated electronic reminders to facilitate primary cardiovascular disease prevention: randomised controlled trial. British Journal of General Practice 2010;60:e137-43. - PMC - PubMed
    1. Holt TA, Thorogood M, Griffiths F, Munday S. Protocol for the 'e-Nudge trial': A randomised controlled trial of electronic feedback to reduce the cardiovascular risk of individuals in general practice [ISRCTN64828380]. Trials 2006;7:11. - PMC - PubMed
Jacobson 2006 {published data only}
    1. Jacobson TA, Gutkin SW, Harper CR. Effects of a global risk educational tool on primary coronary prevention: the Atherosclerosis Assessment ViaTotal Risk (AVIATOR) study. Current Medical Research and Opinion 2006;22:1065-73. - PubMed
Jorgensen 2014 {published data only}
    1. Baumann S, Toft U, Aadahl M, Jorgensen T, Pisinger C. The long-term effect of screening and lifestyle counseling on changes in physical activity and diet: the Inter99 Study - a randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity 2015;12:33. - PMC - PubMed
    1. Jorgensen T, Jacobsen RK, Toft U, Aadahl M, Glumer C, Pisinger C. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population: Inter99 randomised trial. BMJ 2014;348:g3617. - PMC - PubMed
    1. Jorgensen T, Ladelund S, Borch-Johnsen K, Pisinger C, Schrader AM, Thomsen T, et al. Screening for risk of cardiovascular disease is not associated with mental distress: the Inter99 study. Preventive Medicine 2009;48:242-6. - PubMed
    1. Pisinger C, Glumer C, Toft U, Huth Smith L, Aadahl M, Borch-Johnsen K, et al. High risk strategy in smoking cessation is feasible on a population-based level. The Inter99 study. Preventive Medicine 2008;46(6):579-84. - PubMed
    1. Toft U, Kristoffersen L, Ladelund S, Ovesen L, Lau C, Borch-Johnsen K, et al. The impact of a population-based multi-factorial lifestyle intervention on changes in long-term dietary habits: the Inter99 study. Preventive Medicine 2008;47(4):378-83. - PubMed
Koelewijn‐van Loon 2010 {published data only}
    1. Koelewijn-van Loon MS, Weijden T, Ronda G, Steenkiste B, Winkens B, Elwyn G, et al. Improving lifestyle and risk perception through patient involvement in nurse-led cardiovascular risk management: a cluster-randomized controlled trial in primary care. Preventive Medicine 2010;50(1-2):35-44. - PubMed
    1. Koelewijn-van Loon MS, Weijden T, Steenkiste B, Ronda G, Winkens B, Severens JL, et al. Involving patients in cardiovascular risk management with nurse-led clinics: a cluster randomized controlled trial. Canadian Medical Association Journal 2009;181(12):E267-E274. - PMC - PubMed
    1. Koelewijn-van Loon MS, Steenkiste B, Ronda G, Wensing M, Stoffers HE, Elwyn G, et al. Improving patient adherence to lifestyle advice (IMPALA): a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care [protocol]. BMC Health Services Research 2008;8:9. - PMC - PubMed
Krones 2008 {published data only}
    1. Keller H, Krones T, Becker A, Hirsch O, Sonnichsen AC, Popert U, et al. Arriba: effects of an educational intervention on prescribing behaviour in prevention of CVD in general practice. European Journal of Preventive Cardiology 2012;19(3):322-9. - PubMed
    1. Krones T, Keller H, Sonnichsen A, Sadowski EM, Baum E, Wegscheider K, et al. Absolute cardiovascular disease risk and shared decision making in primary care: a randomized controlled trial. Annals of Family Medicine 2008;6:218-27. - PMC - PubMed
Lopez‐Gonzalez 2015 {published data only}
    1. Lopez-Gonzalez AA, Aguilo A, Frontera M, Bennasar-Veny M, Campos I, Vicente-Herrero T, et al. Effectiveness of the Heart Age tool for improving modifiable cardiovascular risk factors in a Southern European population: a randomized trial. European Journal of Preventive Cardiology 2015;22(3):389-96. - PubMed
Lowensteyn 1998 {published data only}
    1. Lowensteyn I, Joseph L, Levinton C, Abrahamowicz M, Steinert Y, Grover S. Can computerized risk profiles help patients improve their coronary risk? The results of the Coronary Health Assessment Study (CHAS). Preventive Medicine 1998;27(5 Pt 1):730-7. - PubMed
Mann 2010 {published data only}
    1. Mann DM, Ponieman D, Montori VM, Arciniega J, McGinn T. The Statin Choice decision aid in primary care: a randomized trial. Patient Education and Counseling 2010;80:138-140. - PubMed
Montgomery 2000 {published data only}
    1. Fahey T, Montgomery AA, Peters TJ. Randomized trial evaluating the framing of cardiovascular risk and its impact on blood pressure control [ISRCTN87597585]. BMC Health Services Research 2001;1:10. - PMC - PubMed
    1. Montgomery AA, Fahey T, Peters TJ, MacIntosh C, Sharp DJ. Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial. BMJ 2000;320:686-90. - PMC - PubMed
Montgomery 2003 {published data only}
    1. Emmett CL, Montgomery AA, Peters TJ, Fahey T. Three-year follow-up of a factorial randomised controlled trial of two decision aids for newly diagnosed hypertensive patients. British Journal of General Practice 2005;55:551-3. - PMC - PubMed
    1. Montgomery AA, Fahey T, Peters TJ. A factorial randomised controlled trial of decision analysis and an information video plus leaflet for newly diagnosed hypertensive patients. British Journal of General Practice 2003;53:446-53. - PMC - PubMed
Peiris 2015 {published data only}
    1. Panaretto KS, Peiris D, Usherwood T, Harris M, Hunt J, Patel A. Health Tracker: does electronic decision support improve identification and management of cardiovascular risk in Australian primary health care? Circulation 2012;125:e808.
    1. Peiris D, Usherwood T, Panaretto K, Harris M, Hunt J, Patel B, et al. The treatment of cardiovascular risk in primary care using electronic decision support (TORPEDO) study: Intervention development and protocol for a cluster randomised, controlled trial of an electronic decision support and quality improvement intervention in Australian primary healthcare. BMJ Open 2012;2(6):e002177. - PMC - PubMed
    1. Peiris D, Usherwood T, Panaretto K, Harris M, Hunt J, Redfern J, et al. Effect of a computer-guided, quality improvement program for cardiovascular disease risk management in primary health care: the treatment of cardiovascular risk using electronic decision support cluster-randomized trial. Circulation: Cardiovascular Quality and Outcomes 2015;8:87-95. - PubMed
    1. Peiris D, Usherwood T, Panaretto K, Harris M, Hunt J, Zwar N, et al. Effect of a multi-faceted quality improvement intervention to improve cardiovascular disease risk identification and management in Australian primary health care: the torpedo cluster-randomised trial. Global Heart 2014;9:e28.
Perestelo‐Perez 2016 {published data only}
    1. Perestelo-Perez L, Rivero-Santana A, Boronat M, Sanchez-Afonso JA, Perez-Ramos J, Montori VM, et al. Effect of the statin choice encounter decision aid in Spanish patients with type 2 diabetes: a randomized trial. Patient Education and Counseling 2016;99(2):295-9. - PubMed
Persell 2013 {published data only}
    1. Persell SD, Lloyd-Jones DM, Friesema EM, Cooper AJ, Baker DW. Electronic health record-based patient identification and individualized mailed outreach for primary cardiovascular disease prevention: a cluster randomized trial. Journal of General Internal Medicine 2013;28(4):554-60. - PMC - PubMed
    1. Persell SD, Lloyd-Jones DM, Friesma EM, Cooper AJ, Baker DW. Electronic health record-based patient identification and individualized mailed outreach for primary cardiovascular disease prevention: a cluster randomized trial. Journal of General Internal Medicine 2012;27:S181-2. - PMC - PubMed
Persell 2015 {published data only}
    1. Persell SD, Brown T, Lee JY, Shah S, Henley E, Long T, et al. Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial. Circulation: Cardiovascular Quality and Outcomes 2015;8(6):560-6. - PubMed
    1. Persell SD, Shah S, Brown T, Lee JY, Sanchez T, Knight RG, et al. Individualized risk communication and lay outreach for the primary prevention of cardiovascular disease in community health centers: a randomized controlled trial. Circulation 2014;130:A14008. - PubMed
    1. Shah S, Brown T, Lee JY, Jean-Jacques M, Kandula NR, Persell SD. Individualized risk communication and lay outreach for the primary prevention of cardiovascular disease in community health centers: preliminary results of a randomized controlled trial. Journal of General Internal Medicine 2014;29:S126.
Price 2011 {published data only}
    1. Price HC, Griffin SJ, Holman RR. Impact of personalized cardiovascular disease risk estimates on physical activity-a randomized controlled trial. Diabetic Medicine 2011;28(3):363-72. - PubMed
    1. Price HC, Tucker L, Griffin SJ, Holman RR. The impact of individualised cardiovascular disease (CVD) risk estimates and lifestyle advice on physical activity in individuals at high risk of CVD: a pilot 2 x 2 factorial understanding risk trial. Cardiovascular Diabetology 2008;7:21. - PMC - PubMed
Sheridan 2006 {published data only}
    1. Sheridan SL, Shadle J, Simpson RJ Jr, Pignone MP. The impact of a decision aid about heart disease prevention on patients' discussions with their doctor and their plans for prevention: a pilot randomized trial. BMC Health Services Research 2006;6:121. - PMC - PubMed
Sheridan 2011 {published data only}
    1. Sheridan SL, Draeger LB, Pignone MP, Keyserling TC, Simpson RJ Jr, Rimer B, et al. A randomized trial of an intervention to improve use and adherence to effective coronary heart disease prevention strategies. BMC Health Services Research 2011;11:331. - PMC - PubMed
    1. Sheridan SL, Draeger LB, Pignone MP, Rimer B, Bangdiwala SI, Cai J, et al. The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial. BMC Medical Informatics and Decision Making 2014;14:14. - PMC - PubMed
Soureti 2011 {published data only}
    1. Soureti A, Murray P, Cobain M, Mechelen W, Hurling R. Web-based risk communication and planning in an obese population: exploratory study. Journal of Medical Internet Research 2011;13:e100. - PMC - PubMed
Turner 2012 {published data only}
    1. Turner BJ, Hollenbeak CS, Liang Y, Pandit K, Joseph S, Weiner MG. A randomized trial of peer coach and office staff support to reduce coronary heart disease risk in African-Americans with uncontrolled hypertension. Journal General Internal Medicine 2012;27:1258-64. - PMC - PubMed
Vagholkar 2014 {published and unpublished data}
    1. Vagholkar S, Zwar N, Jayasinghe UW, Denney-Wilson E, Patel A, Campbell T, et al. Influence of cardiovascular absolute risk assessment on prescribing of antihypertensive and lipid-lowering medications: a cluster randomized controlled trial. American Heart Journal 2014;167(1):28-35. - PubMed
    1. Wan Q, Harris MF, Zwar N, Campbell T, Patel A, Vagholkar S, et al. Study protocol for a randomized controlled trial: the feasibility and impact of cardiovascular absolute risk assessment in Australian general practice. American Heart Journal 2009;157:436-41. - PubMed
Van Steenkiste 2007 {published data only}
    1. Van Steenkiste B, Weijden T, Stoffers HE, Kester AD, Timmermans DR, Grol R. Improving cardiovascular risk management: a randomized, controlled trial on the effect of a decision support tool for patients and physicians. European Journal of Prevention and Rehabilitation 2007;14:44-50. - PubMed
    1. Van Steenkiste B, Weijden TM, Stoffers JH, Grol RP. Patients' responsiveness to a decision support tool for primary prevention of cardiovascular diseases in primary care 1498. Patient Education and Counseling 2008;72(1):63-70. - PubMed
Webster 2010 {published data only}
    1. Webster R, Li SCh, Sullivan DR, Jayne K, Su SY, Neal B. Effects of internet-based tailored advice on the use of cholesterol-lowering interventions: a randomized controlled trial. Journal of Medical Internet Research 2010;12(3):e42. - PMC - PubMed
Welschen 2012 {published data only}
    1. Welschen LM, Bot SD, Dekker JM, Timmermans DR, Weijden T, Nijpels G. The @RISK Study: Risk communication for patients with type 2 diabetes: design of a randomised controlled trial. BMC Public Health 2010;10:457. - PMC - PubMed
    1. Welschen LM, Bot SD, Kostense PJ, Dekker JM, Timmermans DR, Weijden T, et al. Effects of cardiovascular disease risk communication for patients with type 2 diabetes on risk perception in a randomized controlled trial: the @RISK study. Diabetes Care 2012;35:2485-92. - PMC - PubMed
    1. Welschen LMC, Bot SDM, Weijden T, Timmermans DRM, Dekker JM, Nijpels G. Cardiovascular disease risk communication for patients with type 2 diabetes: the @RISK study. Diabetologia 2010;53:S487.
Williams 2006 {published data only}
    1. Williams GC, McGregor H, Sharp D, Kouides RW, Levesque CS, Ryan RM, et al. A self-determination multiple risk intervention trial to improve smokers' health. Journal of General Internal Medicine 2006;21:1288-94. - PMC - PubMed
    1. Williams GC, Minicucci DS, Kouides RW, Levesque CS, Chirkov VI, Ryan RM, et al. Self-determination, smoking, diet and health. Health Education Research 2002;17(5):512-21. - PubMed
Wister 2007 {published data only}
    1. Wister A, Loewen N, Kennedy-Symonds H, McGowan B, McCoy B, Singer J. One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk. Canadian Medical Association Journal 2007;177(8):859-65. - PMC - PubMed
Zullig 2014 {published data only}
    1. Zullig LL, Sanders LL, Shaw RJ, McCant F, Danus S, Bosworth HB. A randomised controlled trial of providing personalised cardiovascular risk information to modify health behaviour. Journal of Telemedicine and Telecare 2014;20:147-52. - PubMed

References to studies excluded from this review

Ajay 2014 {published data only}
    1. Ajay VS, Tian M, Chen H, Wu Y, Li X, Dunzhu D, et al. A cluster-randomized controlled trial to evaluate the effects of a simplified cardiovascular management program in Tibet, China and Haryana, India: study design and rationale. BMC Public Health 2014;14:924. - PMC - PubMed
Allen 2011 {published data only}
    1. Allen JK, Dennison-Himmelfarb CR, Szanton SL, Bone L, Hill MN, Levine DM, et al. Community Outreach and Cardiovascular Health (COACH) Trial: a randomized, controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers. Circulation: Cardiovascular Quality and Outcomes 2011;4(6):595-602. - PMC - PubMed
Avis 1989 {published data only}
    1. Avis NE, Smith KW, McKinlay JB. Accuracy of perceptions of heart attack risk: what influences perceptions and can they be changed? American Journal of Public Health 1989;79(12):1608-12. - PMC - PubMed
Baruth 2011 {published data only}
    1. Baruth M, Wilcox S, Sallis JF, King AC, Marcus BH, Blair SN. Changes in CVD risk factors in the activity counseling trial. International Journal of General Medicine 2011;4:53-62. - PMC - PubMed
Berra 2007 {published data only}
    1. Berra K, Ma J, Klieman L, Hyde S, Monti V, Guardado A, et al. Implementing cardiac risk-factor case management: lessons learned in a county health system. Critical Pathways in Cardiology 2007;6:173-9. - PubMed
Bjarnason‐Wehrens 2013 {published data only}
    1. Bjarnason-Wehrens B, Albus C, Heming C, Gysan D, Herold G, Latsch J, et al. Can a multimodale intervention improve exercise capacity in patients with high cardiovascular risk on a sustained basis-the PreFord-study. European Journal of Preventive Cardiology 2013;20:S3.
    1. Predel HG, Gysan DB, Albus C, Bjarnason-Wehrens B, Gohlke H, Latsch J, et al. Substantial improvement of primary cardiovascular prevention by a systematic score-based multimodal and lifestyle approach: a randomized endpoint-study-the Preford-study. Circulation 20115;132:A17097. - PubMed
Black 2014 {published data only}
    1. Black JA, Sharp SJ, Wareham NJ, Sandbaek A, Rutten GE, Lauritzen T, et al. Does early intensive multifactorial therapy reduce modelled cardiovascular risk in individuals with screen-detected diabetes? Results from the ADDITION-Europe cluster randomized trial. Diabetic Medicine 2014;31:647-656. - PMC - PubMed
Botija‐Yague 2007 {published data only}
    1. Botija-Yague MP, Lizan-Tudela L, Gosalbes-Soler V, Bonet-Pla A, Fornos-Garrigos A. How does intensive therapy to control cardiovascular risk factors affect health-related quality of life in diabetic patients? [¿Cómo influye el trata- miento intensivo de los factores de riesgo cardiovascular en la calidad de vida relacionada con la salud de los pacientes diabéticos?]. Atencion Primaria 2007;39:227-34. - PMC - PubMed
Branda 2013 {published data only}
    1. Branda ME, LeBlanc A, Shah ND, Tiedje K, Ruud K, Van Houten H, et al. Shared decision making for patients with type 2 diabetes: a randomized trial in primary care. BMC Health Services Research 2013;13:301. - PMC - PubMed
Brett 2012 {published data only}
    1. Brett T, Arnold-Reed D, Phan C, Cadden F, Walker W, Manea-Walley W, et al. The Fremantle Primary Prevention Study: a multicentre randomised trial of absolute cardiovascular risk reduction. British Journal of General Practice 2012;62:e22-8. - PMC - PubMed
Bruckert 2008 {published data only}
    1. Bruckert E, Giral P, Paillard F, Ferrières J, Schlienger JL, Renucci JF, et al. Effect of an educational program (PEGASE) on cardiovascular risk in hypercholesterolaemic patients. Cardiovascular Drugs and Therapy 2008;22:495-505. - PubMed
Carrington 2012 {published data only}
    1. Carrington MJ, Schute F, Haluska B, Marwick TH, Holliday J, Stewart S. Preliminary results of the impress study: reducing cardiovascular risk factors in a nurse-led primary intervention program for high risk participants. European Heart Journal 2012;33:1063.
CARRS 2012 {published data only}
    1. CARRS Trial Writing Group, Shah S, Singh K, Ali MK, Mohan V, Kadir MM, et al. Improving diabetes care: multi-component cardiovascular disease risk reduction strategies for people with diabetes in South Asia--the CARRS multi-center translation trial. Diabetes Research and Clinical Practice 2012;98(2):285-94. - PMC - PubMed
Carter 2009 {published data only}
    1. Carter M, Karwalajtys T, Chambers L, Kaczorowski J, Dolovich L, Gierman T, et al. Implementing a standardized community-based cardiovascular risk assessment program in 20 Ontario communities. Health Promotion International 2009;24(4):325-33. - PubMed
Carter 2015 {published data only}
    1. Carter BL, Coffey CS, Chrischilles EA, Ardery G, Ecklund D, Gryzlak B, et al. A cluster-randomized trial of a centralized clinical pharmacy cardiovascular risk service to improve guideline adherence. Pharmacotherapy 2015;35(7):653-62. - PMC - PubMed
Chow 2009 {published data only}
    1. Chow CK, Joshi R, Gottumukkala AK, Raju K, Raju R, Reddy S, et al. Rationale and design of the Rural Andhra Pradesh Cardiovascular Prevention Study (RAPCAPS): a factorial, cluster-randomized trial of 2 practical cardiovascular disease prevention strategies developed for rural Andhra Pradesh, India. American Heart Journal 2009;158:349-55. - PubMed
Claes 2007 {published data only}
    1. Claes N, Jacobs N. The PreCardio-study protocol--a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme. BMC Cardiovascular Disorders 2007;7:27. - PMC - PubMed
Cleveringa 2008 {published data only}
    1. Cleveringa FG, Gorter KJ, den Donk M, Rutten GE. Combined task delegation, computerized decision support, and feedback improve cardiovascular risk for type 2 diabetic patients: a cluster randomized trial in primary care. Diabetes Care 2008;31:2273-5. - PMC - PubMed
    1. Cleveringa FG, Welsing PM, den Donk M, Gorter KJ, Niessen LW, Rutten GE, et al. Cost-effectiveness of the diabetes care protocol, a multifaceted computerized decision support diabetes management intervention that reduces cardiovascular risk. Diabetes Care 2010;33(2):258-63. - PMC - PubMed
    1. Cleveringa FGW, Gorter KJ, den Donk M, Rutten GEH. Task delegation and computerised decision support improve cardiovascular risk for type 2 diabetes patients. A randomised controlled trial in primary care. Diabetologia 2007;50:S117.
Cochrane 2012 {published data only}
    1. Cochrane T, Davey R, Iqbal Z, Gidlow C, Kumar J, Chambers R, et al. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction. BMC Public Health 2012;12:944. - PMC - PubMed
Colwell 2011 {published data only}
    1. Colwell B, Mathers N, Bradley A, Ng CJ. Does a PDA improve knowledge about treatment choices for patients with type 2 diabetes mellitus when making decisions about starting insulin? Quantitative analysis from the PANDAs study. Diabetologia 2011;54:S406.
Daniels 2012 {published data only}
    1. Daniels EC, Powe BD, Metoyer T, McCray G, Baltrus P, Rust GS. Increasing knowledge of cardiovascular risk factors among African Americans by use of community health workers: the ABCD community intervention pilot project. Journal of the National Medical Association 2012;104(3-4):179-85. - PMC - PubMed
Deales 2014 {published data only}
    1. Deales A, Fratini M, Romano S, Rappelli A, Penco M, Perna GP, et al. Care manager to control cardiovascular risk factors in primary care: the Raffaello cluster randomized trial. Nutrition, Metabolism & Cardiovascular Diseases 2014;24:563-71. - PubMed
    1. Romano S, Rappelli A, Musilli A, Perna G, Fratini M, Manzoli L, et al. Project Raffaello: Application and evaluation of the disease and care management approach in cardiovascular disease prevention. European Heart Journal 2011;32:219.
Dresser 2009 {published data only}
    1. Dresser GK, Moor R, Khan R, Khanna R, Har BJ. Compliance with prescribed therapy and patient perceptions in the treatment of hypertension. Journal of Clinical Hypertension 2009;11:A57.
Edwards 2006 {published data only}
    1. Edwards A, Thomas R, Williams R, Ellner AL, Brown P, Elwyn G. Presenting risk information to people with diabetes: evaluating effects and preferences for different formats by a web-based randomised controlled trial. Patient Education and Counseling 2006;63:336-49. - PubMed
El Fakiri 2008 {published data only}
    1. El Fakiri F, Bruijnzeels MA, Uitewaal PJ, Frenken RA, Berg M, Hoes AW. Intensified preventive care to reduce cardiovascular risk in healthcare centres located in deprived neighbourhoods: a randomized controlled trial. European Journal of Cardiovascular Prevention and Rehabilitation 2008;15:488-93. - PubMed
Evans 2010 {published data only}
    1. Evans CD, Eurich DT, Taylor JG, Blackburn DF. The Collaborative Cardiovascular Risk Reduction in Primary Care (CCARP) study. Pharmacotherapy 2010;30(8):766-75. - PubMed
Fabregas 2014 {published data only}
    1. Fàbregas M, Berges I, Fina F, Hermosilla E, Coma E, Méndez L, et al. Effectiveness of an intervention designed to optimize statins use: a primary prevention randomized clinical trial. BMC Family Practice 2014;15:135. - PMC - PubMed
Fretheim 2006 {published data only}
    1. Fretheim A, Oxman AD, Havelsrud K, Treweek S, Kristoffersen DT, Bjorndal A. Rational prescribing in primary care (RaPP): a cluster randomized trial of a tailored intervention. PLOS Medicine 2006;3(6):e134. - PMC - PubMed
    1. Fretheim A, Oxman AD, Treweek S, Bjorndal A. Rational Prescribing in Primary Care (RaPP-trial). A randomised trial of a tailored intervention to improve prescribing of antihypertensive and cholesterol-lowering drugs in general practice [ISRCTN48751230]. BMC Health Services Research 2003;3:5. - PMC - PubMed
Freund 2015 {published data only}
    1. Freund N, Friedli BC, Junker T, Zimmermann M, Zellweger MJ. Cardiovascular risk assessment and effects on behavior in Switzerland: the Swiss Heart Foundation HerzCheck(R)/Cardio-Test(R). Open Cardiovascular Medicine Journal 2015;9:35-9. - PMC - PubMed
Gill 2009 {published data only}
    1. Gill JM, Chen YX, Glutting JJ, Diamond JJ, Lieberman MI. Impact of decision support in electronic medical records on lipid management in primary care. Population Health Management 2009;12(5):221-6. - PubMed
Gomez‐Marcos 2006 {published data only}
    1. Gomez-Marcos MA, Ortiz LG, Gonzalez-Elena LJ, Rodriguez AS. Effectiveness of an intervention to improve quality care in reducing cardiovascular risk in hypertensive patients [Efectividad de una intervención de mejora de calidad en la reducción del riesgo coronario y del riesgo de mortalidad cardiovascular en pacientes hipertensos]. Atencion Primaria 2006;37:498-503. - PMC - PubMed
Green 2014 {published data only}
    1. Green BB, Anderson ML, Cook AJ, Catz S, Fishman PA, McClure JB, et al. e-Care for heart wellness: a feasibility trial to decrease blood pressure and cardiovascular risk. American Journal of Preventive Medicine 2014;46(4):368-77. - PMC - PubMed
Harmsen 2014 {published data only}
    1. Harmsen CG, Jarbøl DE, Nexøe J, Støvring H, Gyrd-Hansen D, Nielsen JB, et al. Impact of effectiveness information format on patient choice of therapy and satisfaction with decisions about chronic disease medication: the Influence of intervention Methodologies on Patient Choice of Therapy (IMPACT) cluster-randomised trial in general practice. BMC Health Services Research 2013;13:76. - PMC - PubMed
    1. Harmsen CG, Kristiansen IS, Larsen PV, Nexoe J, Stovring H, Gyrd-Hansen D, et al. Communicating risk using absolute risk reduction or prolongation of life formats: cluster-randomised trial in general practice. The British Journal of General Practice 2014;64(621):e199-207. - PMC - PubMed
Holbrook 2011 {published data only}
    1. Holbrook A, Pullenayegum E, Thabane L, Troyan S, Foster G, Keshavjee K, et al. Shared electronic vascular risk decision support in primary care: Computerization of Medical Practices for the Enhancement of Therapeutic Effectiveness (COMPETE III) randomized trial. Archives of Internal Medicine 2011;171(19):1736-44. - PubMed
Hormigo‐Pozo 2009 {published data only}
    1. Hormigo-Pozo A, Viciana-Lopez MA, Gomez-Jimenez L, Gallego-Parrilla MD, Orellana-Lozano J, Morales-Asencio JM. Improved effectiveness in the management of cardiovascular risk among type 2 diabetic patients in primary health care [Mejora de la efectividad en el manejo del riesgo cardiovascular de pacientes diabéticos tipo 2 en atención primaria]. Atencion Primaria 2009;41:240-5. - PMC - PubMed
Huntink 2013 {published data only}
    1. Huntink E, Heijmans N, Wensing M, Lieshout J. Effectiveness of a tailored intervention to improve cardiovascular risk management in primary care: study protocol for a randomised controlled trial. Trials 2013;14(1):433. - PMC - PubMed
Ishani 2011 {published data only}
    1. Ishani A, Greer N, Taylor BC, Kubes L, Cole P, Atwood M, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: a randomized controlled trial. Diabetes Care 2011;34:1689-94. - PMC - PubMed
Jacobs 2011 {published data only}
    1. Jacobs N, Drost R, Ament A, Evers S, Claes N. Willingness to pay for a cardiovascular prevention program in highly educated adults: a randomized controlled trial. International Journal of Technology Assessment in Health Care 2011;27(4):283-9. - PubMed
Jennings 2006 {published data only}
    1. Jennings C, Wood D. EUROACTION: a family-based preventive cardiology programme in primary care. Practical Cardiovascular Risk Management 2006;4:12-15.
Jones 2009 {published data only}
    1. Jones LA, Weymiller AJ, Shah N, Bryant SC, Christianson TJ, Guyatt GH, et al. Should clinicians deliver decision aids? Further exploration of the statin choice randomized trial results. Medical Decision Making 2009;29:468-74. - PubMed
Kaczorowski 2011 {published data only}
    1. Kaczorowski J, Chambers LW, Dolovich L, Paterson JM, Karwalajtys T, Gierman T, et al. Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP). BMJ 2011;342:d442. - PMC - PubMed
    1. Kaczorowski J, Chambers LW, Karwalajtys T, Dolovich L, Farrell B, McDonough B, et al. Cardiovascular Health Awareness Program (CHAP): a community cluster-randomised trial among elderly Canadians. Preventive Medicine 2008;46(6):537-44. - PubMed
    1. Kaczorowski JA, Chambers LW, Dolovich L, Farrell B, McDonough B, Sebaldt R, et al. Improving cardiovascular health at the population level: a 39 community cluster randomized trial of the Cardiovascular Health Awareness Program (C-CHAP). Stroke 2010;41:e474.
Ketola 2001 {published data only}
    1. Ketola E, Mäkelä M, Klockars M. Individualised multifactorial lifestyle intervention trial for high-risk cardiovascular patients in primary care. British Journal of General Practice 2001;51:291-4. - PMC - PubMed
Keyserling 2014 {published data only}
    1. Keyserling TC, Sheridan SL, Draeger LB, Finkelstein EA, Gizlice Z, Kruger E, et al. A comparison of live counseling with a web-based lifestyle and medication intervention to reduce coronary heart disease risk: a randomized clinical trial. JAMA Internal Medicine 2014;174(7):1144-57. - PMC - PubMed
    1. Sheridan SL, Draeger LB, Pignone MP, Sloane PD, Samuel-Hodge C, Finkelstein EA, et al. Designing and implementing a comparative effectiveness study of two strategies for delivering high quality CHD prevention: methods and participant characteristics for the Heart to Health study. Contemporary Clinical Trials 2013;36(2):394-405. - PMC - PubMed
    1. Sheridan SL, Keyserling TC, Draeger LB. A randomized trial of a web-based versus counselor based intervention to reduce CHD risk. Journal of General Internal Medicine 2013;28:S13.
Kullo 2016 {published data only}
    1. Brown SA, Jouni H, Austin E, Marroush T, Kullo I. Effect of disclosure of genetic risk for coronary heart disease on information seeking and information sharing in a randomized clinical trial (from the MI-GENES Investigators). Circulation 2015;132:A16508.
    1. Kullo IJ, Jouni H, Austin EE, Brown SA, Kruisselbrink TM, Isseh IN, et al. Incorporating a genetic risk score into coronary heart disease risk estimates: effect on low-density lipoprotein cholesterol levels (the MI-GENES Clinical Trial). Circulation 2016;133(12):1181-8. - PMC - PubMed
    1. Kullo IJ, Jouni H, Olson JE, Montori VM, Bailey KR. Design of a randomized controlled trial of disclosing genomic risk of coronary heart disease: the Myocardial Infarction Genes (MI-GENES) study. BMC Medical Genomics 2015;8:51. - PMC - PubMed
    1. Robinson CL, Jouni H, Kruisselbrink TM, Austin EE, Christensen KD, Green RC, et al. Disclosing genetic risk for coronary heart disease: effects on perceived personal control and genetic counseling satisfaction. Clinical Genetics 2016;89(2):251-7. - PMC - PubMed
    1. Robinson CL, Jouni H, Kruisselbrink TM, Christensen KD, Green RC, Kullo IJ. The effect of disclosing genetic risk for coronary heart disease on perceived personal control and genetic counseling satisfaction: the MI-genes study. Circulation 2014;130:A20188. - PMC - PubMed
Laan 2012 {published data only}
    1. Laan EK, Kraaijenhagen RA, Peek N, Busschers WB, Deutekom M, Bossuyt PM, et al. Effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour: study protocol. BMC Public Health 2012;12:200. - PMC - PubMed
Lalonde 2004 {published data only}
    1. Lalonde L, O'Connor AM, Drake E, Duguay P, Lowensteyn I, Grover SA. Development and preliminary testing of a patient decision aid to assist pharmaceutical care in the prevention of cardiovascular disease. Pharmacotherapy 2004;24:909-22. - PubMed
Lalonde 2006 {published data only}
    1. Lalonde L, O'Connor AM, Duguay P, Brassard J, Drake E, Grover SA. Evaluation of a decision aid and a personal risk profile in community pharmacy for patients considering options to improve cardiovascular health: the OPTIONS pilot study. International Journal of Pharmacy Practice 2006;14:51-62.
Lauritzen 2008 {published data only}
    1. Lauritzen T, Jensen MS, Thomsen JL, Christensen B, Engberg M. Health tests and health consultations reduced cardiovascular risk without psychological strain, increased healthcare utilization or increased costs. An overview of the results from a 5-year randomized trial in primary care. The Ebeltoft Health Promotion Project (EHPP). Scandinavian Journal of Public Health 2008;36(6):650-61. - PubMed
Liddy 2015 {published data only}
    1. Liddy C, Hogg W, Russell G, Wells G, Armstrong CD, Akbari A, et al. Improved delivery of cardiovascular care (IDOCC) through outreach facilitation: study protocol and implementation details of a cluster randomized controlled trial in primary care. Implementation Science 2011;6(1):110. - PMC - PubMed
    1. Liddy C, Hogg W, Singh J, Taljaard M, Russell G, Deri Armstrong C, et al. A real-world stepped wedge cluster randomized trial of practice facilitation to improve cardiovascular care. Implementation Science 2015;10:150. - PMC - PubMed
Lindholm 1995 {published data only}
    1. Lindholm LH, Ekbom T, Dash C, Eriksson M, Tibblin G, Scherstén B. The impact of health care advice given in primary care on cardiovascular risk. BMJ 1995;310:1105-9. - PMC - PubMed
Ma 2009 {published data only}
    1. Ma J, Berra K, Haskell WL, Klieman L, Hyde S, Smith MW, et al. Case management to reduce risk of cardiovascular disease in a county health care system. Archives of Internal Medicine 2009;169(21):1988-95. - PMC - PubMed
Mendis 2010 {published data only}
    1. Mendis S, Johnston SC, Fan W, Oladapo O, Cameron A, Faramawi MF. Cardiovascular risk management and its impact on hypertension control in primary care in low-resource settings: a cluster-randomized trial. Bulletin of the World Health Organization 2010;88(6):412-9. - PMC - PubMed
Mills 2010 {published data only}
    1. Mills M, Loney P, Jamieson E, Gafni A, Browne G, Bell B, et al. A primary care cardiovascular risk reduction clinic in Canada was more effective and no more expensive than usual on-demand primary care--a randomised controlled trial. Health & Social Care in the Community 2010;18:30-40. - PubMed
Mortsiefer 2015 {published data only}
    1. Mortsiefer A, Meysen T, Schumacher M, Abholz HH, Wegscheider K, In der Schmitten J. From hypertension control to global cardiovascular risk management: an educational intervention in a cluster-randomised controlled trial. BMC Family Practice 2015;16:56. - PMC - PubMed
NCT01134458 {unpublished data only}
    1. NCT01134458. Personalized cardiovascular risk information to initiate and maintain health behavior changes (FIMDM_CVD) [Personalized Cardiovascular Risk Information to Initiate and Maintain Health Behavior Changes]. clinicaltrials.gov/ct2/show/NCT01134458 (first received 28 May 2010).
NCT01979471 {unpublished data only}
    1. NCT01979471. The Alberta vascular risk reduction community pharmacy project: RxEACH (RxEACH) [The Alberta Vascular Risk Reduction Community Pharmacy Project: RxEACH]. clinicaltrials.gov/ct2/show/NCT01979471 (first received 1 November 2013).
Nebieridze 2011 {published data only}
    1. Nebieridze D, Safarian AS, Shalnova SA, Deev AD, Oganov RG. The efficacy of integration in clinical practice of electronic version of SCORE in treating hypertensive patients. European Journal of Cardiovascular Prevention and Rehabilitation 2011;18:S81.
Paterson 2002 {published data only}
    1. Paterson JM, Llewellyn-Thomas HA, Naylor CD. Using disease risk estimates to guide risk factor interventions: field test of a patient workbook for self-assessing coronary risk. Health Expectations 2002;5(1):3-15. - PMC - PubMed
Pignone 2004 {published data only}
    1. Pignone M, Sheridan SL, Lee YZ, Kuo J, Phillips C, Mulrow C, et al. Heart to Heart: a computerized decision aid for assessment of coronary heart disease risk and the impact of risk-reduction interventions for primary prevention. Preventive Cardiology 2004;7(1):26-33. - PubMed
Powers 2011 {published data only}
    1. Powers BJ, Danus S, Grubber JM, Olsen MK, Oddone EZ, Bosworth HB. The effectiveness of personalized coronary heart disease and stroke risk communication. American Heart Journal 2011;161(4):673-80. - PubMed
Qureshi 2012 {published data only}
    1. Qureshi N, Armstrong S, Dhiman P, Saukko P, Middlemass J, Evans PH, et al. Effect of adding systematic family history enquiry to cardiovascular disease risk assessment in primary care: a matched-pair, cluster randomized trial. Annals of Internal Medicine 2012;156(4):253-62. - PubMed
Reid 1995 {published data only}
    1. Reid C, McNeil JJ, Williams F, Powles J. Cardiovascular risk reduction: a randomized trial of two health promotion strategies for lowering risk in a community with low socioeconomic status. Journal of Cardiovascular Risk 1995;2:155-63. - PubMed
Rodriguez‐Salceda 2010 {published data only}
    1. Rodriguez-Salceda I, Escortell-Mayor E, Rico-Blazquez M, Riesgo-Fuertes R, Asunsolo-del Barco A, Valdivia-Perez A, et al. EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting. BMC Public Health 2010;10:449. - PMC - PubMed
Selvaraj 2012 {published data only}
    1. Selvaraj FJ, Mohamed M, Omar K, Nanthan S, Kusiar Z, Subramaniam SY, et al. The impact of a disease management program (COACH) on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (the DISSEMINATE Study): a randomised controlled trial. BMC Family Practice 2012;13:97. - PMC - PubMed
Sheridan 2012 {published data only}
    1. Sheridan SL, Draeger LB, Pignone M, Keyserling TC. Patients' choices for lifestyle change versus medication use to reduce elevated CVD risk. Journal of General Internal Medicine 2012;27:S268.
Skinner 2011 {published data only}
    1. Skinner TC, Barrett M, Greenfield C. Impact of providing people with type 2 diabetes with their actual risk for five diabetes complications: A pilot study. Diabetologia 2011;54:S405-S406.
Smith 2008 {published data only}
    1. Smith SA, Shah ND, Bryant SC, Christianson TJH, Bjornsen SS, Giesler PD, et al. Chronic care model and shared care in diabetes: randomized trial of an electronic decision support system. Mayo Clinic Proceedings 2008;83:747-57. - PubMed
Soureti 2010 {published data only}
    1. Soureti A, Hurling R, Murray P, Mechelen W, Cobain M. Evaluation of a cardiovascular disease risk assessment tool for the promotion of healthier lifestyles. European Journal of Cardiovascular Prevention and Rehabilitation 2010;17:519-23. - PubMed
Stewart 2012 {published data only}
    1. Stewart S, Carrington MJ, Swemmer CH, Anderson C, Kurstjens NP, Amerena J, et al. Effect of intensive structured care on individual blood pressure targets in primary care: multicentre randomised controlled trial. BMJ 2012;345:e7156. - PMC - PubMed
    1. Stewart S, Carrington MJ, Swemmer CH, Kurstjens NP, Jennings GJ. A national, multicentre, randomized controlled trial of the efficacy of structured care algorithm in achieving individual blood pressure targets at 26 weeks in primary care. European Heart Journal 2012;33:679.
    1. Stewart S, Carrington MJ, Swemmer CH, Kurstjens NP, Jennings GJ. Reduced blood pressure and risk of future cardiovascular disease from structured care algorithm in primary care patients with persistent hypertension: a multicentere randomized controlled trial. European Heart Journal 2012;33:811.
Thomsen 2001 {published data only}
    1. Thomsen TF, Davidsen M, Ibsen H, Jorgensen T, Jensen G, Borch-Johnsen K. A new method for CHD prediction and prevention based on regional risk scores and randomized clinical trials; PRECARD and the Copenhagen Risk Score. Journal of Cardiovascular Risk 2001;8(5):291-7. - PubMed
Vaidya 2012 {published data only}
    1. Vaidya R, Pandya KV, Denney-Wilson E, Harris M. Sustaining cardiovascular absolute risk management in Australian general practice. Australian Journal of Primary Health 2012;18(4):304-7. - PubMed
Van Breukelen‐van der Stoep 2014 {published data only}
    1. Van Breukelen-van der Stoep DF, Zijlmans J, Van Zeben D, Meulen N, Klop B, Vries MA, et al. Self-reported adherence to cardiovascular risk reduction intervention of patients with rheumatoid arthritis: results of the Francis study. Atherosclerosis 2014;235:e272.
Van den Brekel‐Dijkstra 2016 {published data only}
    1. Van den Brekel-Dijkstra K, Rengers AH, Niessen MA, Wit NJ, Kraaijenhagen RA. Personalized prevention approach with use of a web-based cardiovascular risk assessment with tailored lifestyle follow-up in primary care practice - a pilot study. European Journal of Preventive Cardiology 2016;23(5):544-51. - PubMed
Van Limpt 2011 {published data only}
    1. Van Limpt PM, Harting J, Assema P, Ruland E, Kester A, Gorgels T, et al. Effects of a brief cardiovascular prevention program by a health advisor in primary care; the 'Hartslag Limburg' project, a cluster randomized trial. Preventive Medicine 2011;53(6):395-401. - PubMed
Waldron 2010 {published data only}
    1. Waldron CA, Gallacher J, Weijden T, Newcombe R, Elwyn G. The effect of different cardiovascular risk presentation formats on intentions, understanding and emotional affect: a randomised controlled trial using a web-based risk formatter (protocol). BMC Medical Informatics and Decision Making 2010;10:41. - PMC - PubMed
Weymiller 2007 {published data only}
    1. Weymiller AJ, Montori VM, Jones LA, Gafni A, Guyatt GH, Bryant SC, et al. Helping patients with type 2 diabetes mellitus make treatment decisions: statin choice randomized trial. Archives of Internal Medicine 2007;167(10):1076-82. - PubMed
Zamora 2013 {published data only}
    1. Zamora A, Fernández de Bobadilla F, Carrion C, Vázquez G, Paluzie G, Elosua R, et al. Pilot study to validate a computer-based clinical decision support system for dyslipidemia treatment (HTE-DLP). Atherosclerosis 2013;231:401-4. - PubMed
Zamora 2015 {published data only}
    1. Zamora A, Carrion C, Vazquez G, Martin-Urda A, Vilaseca M, Paluzie G, et al. A clinical decision support system can improves the quality of lipid-lowering therapy in coronary patients. European Heart Journal 2015;36:285-86.
Zhu 2013 {published data only}
    1. Zhu B, Haruyama Y, Muto T, Yamasaki A, Tarumi F. Evaluation of a community intervention program in Japan using Framingham risk score and estimated 10-year coronary heart disease risk as outcome variables: a non-randomized controlled trial. BMC Public Health 2013;13:219. - PMC - PubMed

References to studies awaiting assessment

Adamson 2013 {published data only}
    1. Adamson R, Sourij H, Ring A, Price HC, Holman RR. Adding value to the experience of attending a diabetes clinic appointment: Provision of personalised 10 year cardiovascular disease (CVD) risk estimates. Diabetic Medicine 2013;30:194.
Gryn 2012 {published data only}
    1. Gryn S, Har B, Dresser G. Evaluation of the effect of cardiovascular risk assessment on treatment compliance in hypertension. Journal of Clinical Hypertension 2012;14.
Roach 2012 {published data only}
    1. Roach P, Saha C, Marrero DG. Communicating cardiovascular risk to Latinos with type 2 diabetes using a Spanish language-based multimedia program. Diabetes 2012;61:A88.

References to ongoing studies

Badenbroek 2014 {published data only}
    1. Badenbroek IF, Stol DM, Nielen MM, Hollander M, Kraaijenhagen RA, Wit GA, et al. Design of the INTEGRATE study: effectiveness and cost-effectiveness of a cardiometabolic risk assessment and treatment program integrated in primary care. BMC Family Practice 2014;15:90. - PMC - PubMed
Ijkema 2014 {published data only}
    1. De Koning HJ, Aalst CM, Aerde MA, Ijkema R, Bruggen R, Oudkerk M. Design and recruitment of the ROBINSCA trial: Screening for cardiovascular disease. European Heart Journal 2015;36:985.
    1. Ijkema R, Van Aerde M A, Van Der Aalst C M, Van Ballegooijen M, Oudkerk M, De Koning H J. A randomized controlled trial measuring the effectiveness of screening for cardiovascular disease using classic risk assessment and coronary artery calcium: The ROBINSCA study. European Journal of Preventive Cardiology 2014;21:S21.
Maindal 2014 {published data only}
    1. Maindal HT, Stovring H, Sandbaek A. Effectiveness of the population-based Check your health preventive programme conducted in primary care with 4 years follow-up [the CORE trial]: study protocol for a randomised controlled trial. Trials 2014;15:341. - PMC - PubMed
NCT00694239 {unpublished data only}
    1. NCT00694239. Risk assessment and treat compliance in hypertension education trial (RATCHET) [Evaluation of the Effect of Cardiovascular Risk Assessment in Treatment Compliance in Hypertension]. clinicaltrials.gov/ct2/show/NCT00694239 (first received 6 June 2008).
NCT02096887 {unpublished data only}
    1. NCT02096887. Effect of patient education on compliance and cardiovascular risk parameters (FAILAKA) [Effect of Patient Awareness and Education on Compliance and Cardiovascular Risk Factor Control]. clinicaltrials.gov/ct2/show/NCT02096887 (First received 24 March 2014).
Ogedegbe 2014 {published data only}
    1. Ogedegbe G, Plange-Rhule J, Gyamfi J, Chaplin W, Ntim M, Apusiga K, et al. A cluster-randomized trial of task shifting and blood pressure control in Ghana: study protocol. Implementation Science 2014;9:73. - PMC - PubMed
Praveen 2013 {published data only}
    1. Praveen D, Patel A, McMahon S, Prabhakaran D, Clifford GD, Maulik PK, et al. A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial. Implementation Science 2013;8(1):137. - PMC - PubMed
Redfern 2014 {published data only}
    1. Redfern J, Usherwood T, Harris MF, Rodgers A, Hayman N, Panaretto K, et al. A randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocol. BMJ Open 2014;4:e004523. - PMC - PubMed
Sanghavi 2015 {published data only}
    1. Sanghavi DM, Conway PH. Paying for Prevention: A Novel Test of Medicare Value-Based Payment for Cardiovasculr Risk Reduction. JAMA 2015;314(2):123-124. - PubMed
Silarova 2015 {published data only}
    1. Silarova B, Lucas J, Butterworth AS, Di Angelantonio E, Girling C, Lawrence K, et al. Information and Risk Modification Trial (INFORM): design of a randomised controlled trial of communicating different types of information about coronary heart disease risk, alongside lifestyle advice, to achieve change in health-related behaviour. BMC Public Health 2015;15:868. - PMC - PubMed

Additional references

Anderson 1991
    1. Anderson KM, Odell PM, Wilson PW, Kannel WB. Cardiovascular disease risk profiles. American Heart Journal 1991;121(1 Pt 2):293-8. [PMID: ] - PubMed
Anderson 2013
    1. Anderson TJ, Grégoire J, Hegele RA, Couture P, Mancini GB, McPherson R, et al. 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Canadian Journal of Cardiology 2013;29(2):151-67. [PMID: ] - PubMed
Assmann 2002
    1. Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Münster (PROCAM) study. Circulation 2002;105(3):310-5. [PMID: ] - PubMed
Beswick 2008
    1. Beswick AD, Brindle P, Fahey T, Ebrahim S. A systematic review of risk scoring methods and clinical decision aids used in the primary prevention of coronary heart disease (Supplement). London (UK): Royal College of General Practitioners; May 2008. NICE Clinical Guidelines No. 67S. [PMID: ] - PubMed
Bethesda 1996
    1. No authors listed. 27th Bethesda Conference. Matching the intensity of risk factor management with the hazard for coronary disease events. September 14-15, 1995. Journal of the American College of Cardiology 1996;27(5):957-1047. [PMID: ] - PubMed
Bloom 2011
    1. Bloom DE, Cafiero ET, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum, 2011.
BPLTTC 2014
    1. Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC), Sundström J, Arima H, Woodward M, Jackson R, Karmali K, et al. Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data. Lancet 2014;384(9943):591-8. [PMID: ] - PubMed
Brindle 2006
    1. Brindle P, Beswick A, Fahey T, Ebrahim S. Accuracy and impact of risk assessment in the primary prevention of cardiovascular disease: a systematic review. Heart 2006;92(12):1752-9. [PMID: ] - PMC - PubMed
Conroy 2003
    1. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European Heart Journal 2003;24(11):987-1003. [PMID: ] - PubMed
CTT 2012
    1. Cholesterol Treatment Trialists' (CTT) Collaborators, Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380(9841):581-90. [PMID: ] - PMC - PubMed
Damen 2016
    1. Damen JA, Hooft L, Schuit E, Debray TP, Collins GS, Tzoulaki I, et al. Prediction models for cardiovascular disease risk in the general population: systematic review. BMJ 2016;353:i2416. [PMID: ] - PMC - PubMed
Goff 2014
    1. Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D'Agostino RB Sr, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation 2014;129(25 Suppl 2):S49-73. [PMID: ] - PubMed
Grover 1995
    1. Grover SA, Lowensteyn I, Esrey KL, Steinert Y, Joseph L, Abrahamowicz M. Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study. BMJ 1995;310(6985):975-8. [PMID: ] - PMC - PubMed
Guyatt 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924-6. [PMID: ] - PMC - PubMed
Hajifathalian 2015
    1. Hajifathalian K, Ueda P, Lu Y, Woodward M, Ahmadvand A, Aguilar-Salinas CA, et al. A novel risk score to predict cardiovascular disease risk in national populations (Globorisk): a pooled analysis of prospective cohorts and health examination surveys. Lancet Diabetes & Endocrinology 2015;3(5):339-55. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Hippisley‐Cox 2007
    1. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ 2007;335(7611):136. [PMID: ] - PMC - PubMed
Hippisley‐Cox 2008
    1. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 2008;336(7659):1475-82. [PMID: ] - PMC - PubMed
Jackson 2005
    1. Jackson R, Lawes CM, Bennett DA, Milne RJ, Rodgers A. Treatment with drugs to lower blood pressure and blood cholesterol based on an individual's absolute cardiovascular risk. Lancet 2005;365(9457):434-41. [PMID: ] - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Meland 1994
    1. Meland E, Laerum E, Stensvold I. Assessment of coronary heart disease risk, I. A postal inquiry among primary care physicians. Family Practice 1994;11(2):117-21. [PMID: ] - PubMed
Murray 2012
    1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2197-223. [PMID: ] - PubMed
Naghavi 2015
    1. Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385(9963):117-71. - PMC - PubMed
NCEP 2002
    1. National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002;106(25):3143-421. [PMID: ] - PubMed
NICE 2014
    1. National Institute for Health and Care Excellence (NICE). Lipid modification: Cardiovascular risk assessment and the modification of blood lipids for primary and secondary prevention of cardiovascular disease. www.nice.org.uk/guidance/cg181 (accessed 20 January 2016). - PubMed
O'Donnell 2010
    1. O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010;376(9735):112-23. [PMID: 20561675] - PubMed
Piepoli 2016
    1. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts). European Heart Journal 2016;37(29):2315-81. [PMID: ] - PMC - PubMed
Pignone 2003
    1. Pignone M, Phillips CJ, Elasy TA, Fernandez A. Physicians' ability to predict the risk of coronary heart disease. BMC Health Services Research 2003;3(1):13. [PMID: ] - PMC - PubMed
RevMan 2014 [Computer program]
    1. Review Manager (RevMan). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Sheridan 2008
    1. Sheridan SL, Crespo E. Does the routine use of global coronary heart disease risk scores translate into clinical benefits or harms? A systematic review of the literature. BMC Health Services Research 2008;8:60. [PMID: ] - PMC - PubMed
Sheridan 2010
    1. Sheridan SL, Viera AJ, Krantz MJ, Ice CL, Steinman LE, Peters KE, et al. The effect of giving global coronary risk information to adults: a systematic review. Archives of Internal Medicine 2010;170(3):230-9. [PMID: ] - PubMed
Smith 2004
    1. Smith SC Jr, Jackson R, Pearson TA, Fuster V, Yusuf S, Faergeman O, et al. Principles for national and regional guidelines on cardiovascular disease prevention: a scientific statement from the World Heart and Stroke Forum. Circulation 2004;109(25):3112-21. [PMID: ] - PubMed
Stone 2014
    1. Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129(25 Suppl 2):S1-45. [PMID: ] - PubMed
Usher‐Smith 2015
    1. Usher-Smith JA, Silarova B, Schuit E, Moons KG, Griffin SJ. Impact of provision of cardiovascular disease risk estimates to healthcare professionals and patients: a systematic review. BMJ Open 2015;5(10):e008717. - PMC - PubMed
Van der Weijden 2008
    1. Van der Weijden T, Bos LB, Koelewijn-van Loon MS. Primary care patients' recognition of their own risk for cardiovascular disease: implications for risk communication in practice. Current Opinion in Cardiology 2008;23(5):471-6. [PMID: ] - PubMed
WHO 2007
    1. World Health Organization. Prevention of Cardiovascular Disease: Guidelines for Assessment and Management of Total Cardiovascular Risk. Geneva: WHO Press, 2007.
Willis 2012
    1. Willis A, Davies M, Yates T, Khunti K. Primary prevention of cardiovascular disease using validated risk scores: a systematic review. Journal of Royal Society of Medicine 2012;105(8):348-56. - PMC - PubMed
Wilson 1998
    1. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97(18):1837-47. [PMID: ] - PubMed
Wong 2006
    1. Wong SS, Wilczynski NL, Haynes RB. Developing optimal search strategies for detecting clinically sound treatment studies in EMBASE. Journal of the Medical Library Association 2006;94(1):41-7. - PMC - PubMed
Yusuf 2004
    1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364(9438):937-52. [PMID: ] - PubMed

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