Cardiovascular risk predictors in Primary Health Care: reflections on the adoption of non-laboratory models
DOI:
https://doi.org/10.5712/rbmfc21(48)4494Keywords:
Primary Health Care, Longitudinal Studies, Framingham Heart Study, Cardiovascular RiskAbstract
Introduction: Cardiovascular diseases (CVD) are multifactorial and represent the leading cause of morbidity and mortality in Brazil. Therefore, early identification and management of chronic conditions that act as risk factors are essential. Consequently, cardiovascular risk (CVR) stratifiers were developed to predict the probability of an individual experiencing cardiovascular events over a 10-year period. These tools are important in preventive, therapeutic, and epidemiological contexts, especially in Primary Health Care (PHC). Objective: To discuss the use of CVR stratifiers in PHC, comparing the laboratory-based and non-laboratory-based versions of predictive models (the Framingham Risk 90 Score for Cardiovascular Disease [FRS-CVD] and the HEARTS program calculator, respectively). Methods: This is a cross-sectional, exploratory, and epidemiological study conducted between March 2022 and June 2024, using a convenience sample. The sample included individuals aged 40 to 75 years, with hypertension and/or diabetes, without a history of cardiovascular events, and users of the municipality’s PHC services in São João del Rei (Minas Gerais, Brazil). Participants were required to have serum cholesterol tests performed within the past year. Data from 89 patients were collected and analyzed using Cohen’s kappa coefficient. Results: The sample was predominantly female (68.5%), aged over 60 years (50.5%), and nonsmokers (88.75%). A predominance of intermediate/high risk was observed in both scores, with the HEARTS calculator classifying more individuals as high risk. In contrast, only the FRS-CVD classified patients into very high- or critical-risk categories. The study found minimal agreement between the two tools when assessing the CVR of the same patient. Conclusions: CVR assessment is fundamental in PHC. Clinically, it guides preventive, therapeutic, and educational actions based on patient risk. At the population level, understanding CVR by region helps the formulation of more effective public health policies. However, discrepancies between laboratory and non-laboratory scores may hinder clinical decision-making. Therefore, it is essential to use tools appropriate to the context and develop instruments tailored to the clinical and epidemiological profile of the Brazilian population. This ensures better resource allocation in PHC and greater efficiency in cardiovascular care withing this setting.
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Copyright (c) 2026 Kananda Oliveira Garcia Ruiz, Mariela Svízzero Amaral, Rafael Fonseca Drumond, Vitor de Oliveira Ribeiro, Beatriz Pimentel de Oliveira Andrade, José Victor Ribeiro Silva Gomes, Milena Henriques Fialho, Laila Cristina Moreira Damázio
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