Evaluating Cardiovascular Disease Risk.
Level 5 - mechanism / opinion, no new human data
Narrative review and expert opinion with no original human empirical data
PubMed 41558692 · doi:10.17849/insm-53-1-1-8.2
What was done
This narrative review examined recent cardiovascular disease (CVD) mortality trends, evaluated existing CVD risk calculators, and reviewed non-routine risk biomarkers—specifically apolipoprotein B (apoB), lipoprotein(a) [Lp(a)], systemic inflammation, and insulin resistance—for application in clinical prevention and insurance risk assessment.
What was found
The author reports that the 1960–2020 decline in CVD mortality has reversed, with >228,000 excess CVD deaths through 2022. CDC data cited show that 36% of US adults have no CVD risk factors, 35% have 1, and 29% have 2 or more, with the proportion having ≥2 risk factors increasing between 2013–2014 and 2021–2023. The review emphasizes that apoB and Lp(a) are superior risk predictors compared to LDL alone and highlights systemic inflammation and insulin resistance as critical early CVD indicators.
Why it matters
Highlights the recent reversal in US CVD mortality trends and summarizes the clinical and insurance underwriting rationale for adopting advanced lipid and metabolic biomarkers beyond traditional risk calculators.
Limits
This is an unsystematic narrative review/treatise lacking a formal systematic search methodology, meta-analytic pooling, or original empirical data collection.
Cited by
- supports Heart disease is the leading cause of death in the United States and industrialized nations.