ABSTRACT
INTRODUCTION Cardiovascular disease (CVD) is a leading cause of morbidity and mortality. It is responsible for more than 17 million deaths worldwide every year (31% of total mortality), while in Europe this percentage rises up to 42% (1,2). It is a chronic disorder and usually by the time symptoms occur, CVD is already in an advanced stage. CVD is strongly associated with lifestyle habits (smoking, physical inactivity, unhealthy diet habits, and stress) (3) as well as with several risk factors such as hypertension, diabetes, dyslipidemia, obesity, age, family history of premature coronary heart disease, and endothelial dysfunction (2). Prevention and confrontation of these risk factors represents the cornerstone of CVD treatment. Usually, several risk factors are present in the same patient. Although hypertension represents, probably, the most important and frequent risk factor, only 23% of these patients are free from additional risk factors (4). The majority of the patients present overlapping risk factors (4). The coexistence of different risk factors increases the risk for CV morbidity and mortality exponentially. This phenomenon is well represented in patients with metabolic syndrome because they present a clustering of different risk factors where the risk of CVD is greater than the sum of its individual components (5,6). This led the scientific community to introduce the term total (or global) CV risk factor with the purpose of assessing and managing all the risk factors that every patient presents. This was accomplished with the introduction of different models, scores, or charts that practically estimate the CV risk of every patient under investigation. The European Society of Hypertension (ESH) uses a model that takes into consideration the level of blood pressure, the presence of different risk factors, diabetes, symptomatic CVD, and target organ damage to classify these patients as low, moderate, high, and very high risk according to their probability of having a CV event over a period of 10 years (7) (Figure 3.1).
