P-505: Cardiovascular risk assessment in primary care: a new vital sign? An evidence-based approach for integrating the cardiovascular risk assessment approach in family practice

Abstract

The Framingham Heart Study has taken the lead in developing the concept of risk factors, a concept that is now widely accepted and used. In 2000, the Heart Outcomes Prevention Evaluation Study (HOPE study) has emphasized the importance and benefits of treating high cardiovascular risk patients.

Major organizations see a role for medical office assessment in the detection of risk factors and estimation of total cardiovascular risk. WHO-IHS, JNC-VI and NCEP-ATP-III reports support the idea that cardiovascular risk assessment (CVRA) should be routinely added to the existing screening programs.

A new paradigm in medicine is emerging : CVRA will be more and more present in patients’ files with other parameters like vital signs. Medical office assessment will permit a cardiovascular risk stratification and the identification of high-risk patients. Physicians and patients should be able to set priorities and adjust the intensity of interventions according to cardiovascular risk level.

A national survey (131 physicians) indicated that when using an intuitive method, physicians did not perform well at doing CVRA (53% underestimation for high risk and 42% overestimation for low risk patients). Physicians stated that they were interested to learn new evaluation criteria for CVRA and also, how to adjust medical management and treatment according to CV risk level.

An evidence-based educational tool for family physicians has been developed and disseminated by two Canadian universities (Universite Laval and University of Ottawa) with the support of the Professional Education Department Aventis Pharma Canada. The small group problem-based workshop is aimed at integrating the risk assessment approach into family physician's practice and fostering the development of new skills at doing it. By the end of 2002, it is believed that more than 4000 Canadian physicians will have attended this workshop.

Family Practice, CME, Hypertension, Multifactorial Approach, Cardiovascular Risk Assessment