From the Guidelines
The RISK (Cardiovascular Risk) score is a crucial tool in managing hyperlipidemia and cardiovascular risk, with the SCORE system being a widely used and recommended method for estimating the 10-year risk of fatal cardiovascular disease, as supported by the most recent guidelines from the European Society of Cardiology (1). The SCORE system estimates the 10-year risk of a first fatal atherosclerotic event and is intended to facilitate risk estimation in apparently healthy persons. Key factors incorporated into the SCORE system include age, gender, smoking status, systolic blood pressure, and total cholesterol levels. For primary prevention, statin therapy is typically recommended when the 10-year risk exceeds 7.5-10%, with high-intensity statins for those at highest risk (>20%), and moderate-intensity statins for intermediate risk, as suggested by the comparison of transatlantic approaches to lipid management (1). Risk scores also guide the aggressiveness of LDL-C targets, with higher risk patients generally aiming for lower LDL-C levels. Some of the key considerations in using the SCORE system include:
- The system is designed for use in people without overt cardiovascular disease, diabetes, chronic kidney disease, or very high levels of individual risk factors.
- The SCORE chart is for use in populations at high cardiovascular disease risk based on the risk factors mentioned.
- The electronic version of SCORE, HeartScore, is being modified to take HDL-C into account and is recommended for use to increase the accuracy of risk evaluation (1).
- The use of fatal cardiovascular disease as the endpoint allows accurate re-calibration to other countries and cultures to adjust for different risk profiles (1). Overall, the RISK score, particularly the SCORE system, plays a vital role in the management of hyperlipidemia and cardiovascular risk by providing a standardized method for estimating an individual's risk and guiding evidence-based decisions regarding preventive therapies and lifestyle modifications.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition and Role of RISK Score
- The RISK score is not explicitly defined in the provided studies, but it can be inferred that it refers to the assessment of cardiovascular risk in patients with hyperlipidemia.
- The management of hyperlipidemia and cardiovascular risk involves the use of various lipid management strategies, including statins, ezetimibe, and PCSK9 inhibitors 2, 3, 4.
Assessment of Cardiovascular Risk
- The assessment of cardiovascular risk is crucial in managing hyperlipidemia and involves the use of various biomarkers, including low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B 5.
- Different methods can be used to assess cardiovascular risk, including the Adult Treatment Panel III (ATPIII) and the Systematic Coronary Risk Evaluation (SCORE) 6.
- The choice of method can have significant clinical and economic consequences, with different methods identifying different proportions of high-risk patients and candidates for lipid-lowering treatment 6.
Management of Hyperlipidemia and Cardiovascular Risk
- Statins are the clear first-line agents for the management of hyperlipidemia in patients at high risk for cardiovascular events 2.
- Ezetimibe and PCSK9 inhibitors can be used as additional therapies to reduce cardiovascular risk in patients who are intolerant to statin therapy or who require additional lipid-lowering therapy 3, 4.
- The use of these therapies can reduce the risk of non-fatal myocardial infarction and stroke in adults at very high or high cardiovascular risk who are receiving maximally tolerated statin therapy or are statin-intolerant 4.