الفهرس 
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Abstract
Considering that cardiovascular diseases continue to be
the leading cause of mortality in industrialized countries, more
effort was required to reduce the burden of these diseases. In
this context, lifestyle modifications based on avoiding
smoking, taking regular physical exercise, and improving
control of hypertension could be the most effective
intervention at the population level.
Despite the advances in our understanding of
nontraditional risk factors/biomarkers for CVD, the clinical
utility of nontraditional risk factors/biomarkers for CVD were
limited in young age population because of inconsistent
associations and lack of replication of findings.
With the increasing connection between obesity at young
age and CVD, biomarkers produced from adipose tissue and
those with roles in inflammation and oxidative stress were
increasingly being studied. This knowledge should eventually
lead to the development of more directed therapeutic strategies
to prevent CVD at an early age. It is likely that nontraditional
risk factors/biomarkers could be used as a second layer of
screening to follow interventions or efficacy of therapy and in
Summary
predicting specific patient groups likely to benefit from targeted
interventions.
The current evidence did not support the routine use of
any of the nine risk factors for further risk stratification of
intermediate-risk persons.
According to the American Heart Association and the
Centers for Disease Control and Prevention, we recommend
against the use of hs-CRP as a risk marker in the general
population and against the use of other inflammatory markers
or acute-phase reactants for CHD risk prediction (Class III,
Level of Evidence C). The AHA/ACC recommendation stated
that ”measurement of hs-CRP is an independent marker of risk
and, in those judged at intermediate risk by global risk
assessment (10 to 20% risk of CHD per 10 years), at the
discretion of the physician, may help direct further evaluation
and therapy in the primary prevention of CVD. The benefits of
such therapy based on this strategy remain uncertain. (Class IIa,
Level of Evidence B).”
Homocysteine level, hs-CRP level, carotid IMT, and
CAC score on EBCT may be useful in certain circumstances
but we do not recommend incorporating any emerging risk
Summary
factors into risk assessment for all persons receiving primary
prevention risk assessment.
According to current guidelines provided, we can advise
on screening and identifying asymptomatic individuals at risk
of developing CVD. The objectives of these guidelines were to
reduce the incidence of first or recurrent clinical events due to
coronary heart disease, ischemic stroke, and peripheral artery
disease. The focus is on prevention of disability and early death.
Also we recommend the role of lifestyle changes, the
management of major cardiovascular risk factors and the use of
different prophylactic drug therapies in the prevention of
clinical CVD.
On the other hand, we do not have to consider
cardiovascular risk functions as diagnostic test because their
sensitivity and specificity was low. These risk functions are
screening test that help us to rationalize the selection of patients
to implement different possible primary prevention strategies
and their intensity.