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Why are some cardiovascular disease risk factors, such as family history, not included in the assessment?


Some well known risk factors for cardiovascular disease, such as obesity, are not included in the risk calculations. This is not because they are not important for reducing cardiovascular disease risk, but because either research showed that they did not increase the predictive value of the final equation, or the Framingham Risk Equation has not been specifically assessed in these populations (e.g. the overweight and obese).

Nevertheless, the guidelines do recognise that consideration of these factors is important when completing a comprehensive assessment of absolute risk. The guidelines recommend that a comprehensive risk assessment include:

  • those factors assessed in the risk calculator, as well as
  • consideration of other issues such as the patient's socioeconomic status, family history, cultural and ethnic identity, waist circumference, body mass index, nutrition, alcohol intake, physical activity level and any other related conditions (kidney function, familial hypercholesterolaemia, and atrial fibrillation).


An initiative of the National Vascular Disease Prevention Alliance

Heart Foundation
Stroke Foundation