Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In the past decade CVD has been the cause of over one-third of all premature deaths in Australia. The conventional risk factors for CVD include hypertension, dyslipidemia, smoking and diabetes mellitus. However, in an individual the presence of only one of these factors has a low positive predictive value. The most advanced strategy for coronary risk assessment is therefore to combine the information of several risk factors; a ‘multi-marker’ approach which enhances risk stratification.
Being one of the leading causes of death worldwide, more years of potential life before the age of 75 are lost due to this disease than any other human condition. Fortunately, over the past thirty years significant progress has been made in the areas of diagnosis, prevention and treatment of CVD. One of the most critical advances has been the identification of the major risk factors for CVD which arose from studies such as the Framingham Heart Study and the Seven Countries Study.
The conventional risk factors for CVD include hypertension, smoking, diabetes mellitus, hypercholesterolaemia, hypertriglyceridaemia and low HDL cholesterol. However, in an individual the presence of only one of these factors has a low positive predictive value. Furthermore, a significant number of cardiovascular events still occur in individuals without these established risk indicators. At present, the most advanced strategy for coronary risk assessment is therefore to combine the information of several risk factors. This multi-marker approach can enhance risk stratification, identifying those individuals with a moderate baseline risk who might benefit from aggressive risk reduction strategies. Not only are conventional risk factors assessed, but other CVD biomarkers such as lipoprotein (a), apolipoproteins A & B, homocysteine, fibrinogen and C-reactive protein (CRP) are included.
- Insulin resistance
- Cardiovascular disease
- Statin therapy