Assessing coronary heart disease risk with traditional and novel risk factors

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Abstract
Cardiovascular disease is the leading cause of death in the industrialized world, and a number of well‐characterized factors, including advanced age, hypertension, dyslipidemia, diabetes, and smoking, contribute to cardiovascular risk. Integration of these factors using the Framingham calculation estimates the absolute 10‐year risk for coronary heart disease (CHD), which can be used to guide therapy. Recent studies have demonstrated that additional markers, including elevated lipoprotein(a), homocysteine, sitosterol, and particularly C‐reactive protein (CRP), are also associated with increased risk for CHD. In particular, high‐sensitivity CRP has been shown to identify patients with high CHD risk who may not have elevated low‐density lipoprotein cholesterol (LDL‐C) and may add to the predictive value of the Framing‐ham functions for CHD risk assessment. Assessment of global risk is particularly important in lipid management, as the LDL‐C target goals are determined by risk category.