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The accurate evaluation of cardiovascular disease (CVD) risk in asymptomatic adults is a challenging task. While a basic medical history and standard laboratory tests can provide a rough estimate of risk factor burden, such an estimate is only a rough approximation of risk as many persons suffering CVD events do not necessarily have multiple risk factors, and conversely many who do have multiple risk factors will never suffer a CVD event. In order to best identify asymptomatic persons at risk for future cardiovascular disease (CVD) events, it is important to understand the guidelines for CVD risk assessment and evidence-based methods for evaluation of risk in asymptomatic individuals. In this review, we will 1) discuss the role and limitations of global risk assessment, 2) review the evidence and recommendations for biomarkers in CVD risk assessment, and 3) review the evidence and recommendations for subclinical disease evaluation / imaging in CVD risk assessment.

Evidence based cardiovascular risk assessment: Role of global risk scoring, biomarkers and subclinical disease evaluation