Current and future cardiovascular disease risk assessment in the European Union: an international comparative study

Teresa J Mossakowska, , Catherine L Saunders, Jennie Corbett, Calum MacLure, Eleanor M Winpenny, Elma Dujso, Rupert Payne

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
208 Downloads (Pure)


Risk assessment is central to primary prevention of cardiovascular disease (CVD), but there remains a need to better understand the use of evidence-based interventions in practice. This study examines: (i) the policies and guidelines for risk assessment in Europe, (ii) the use of risk assessment tools in clinical practice and (iii) the barriers to, and facilitators of, risk assessment.
Data were collected from academics, clinicians and policymakers in an online questionnaire targeted at experts from all European Union member states, and in 8 in-depth country case studies that were developed from a targeted literature review and 36 interviews.
The European Society of Cardiology (ESC) produces European guidelines for CVD risk assessment and recommends the Systematic COronary Risk Evaluation tool, which is the most widely used risk assessment tool in Europe. The use of risk assessment tools is variable. Lack of time and resources are important barriers. Integrating risk assessment tools into clinical systems and providing financial incentives to carry out risk assessments could increase implementation. Novel biomarkers would need to be supported by evidence of their clinical effectiveness and cost-effectiveness to be introduced in clinical practice. These findings were consistent across Europe.
Efforts to improve the assessment of CVD risk in clinical practice should be carried out by or in collaboration with, the ESC. Increasing the use of existing risk assessment tools is likely to offer greater gains in primary prevention than the development of novel biomarkers.
Original languageEnglish
Pages (from-to)1-7
JournalEuropean Journal of Public Health
Early online date4 Jan 2018
Publication statusE-pub ahead of print - 4 Jan 2018


  • primary prevention
  • european society of cardiology
  • Cardiovascular diseases
  • risk assessment
  • european union
  • biological markers
  • cost effectiveness
  • cardiovascular disease risk factors


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