Table 1 Characteristics of included systematic reviews

Brindle 2006 [16]

The impact of assessing CVD risk (in the primary prevention of CVD) on clinical outcomes

Any age, free from symptomatic CVD. Patients with diabetes, raised risk factors or preventive treatment eligible

Use of a cardiovascular risk score by healthcare professional

Usual care with appropriate treatment and lifestyle recommendations

(1) CVD or CHD fatal or non-fatal events,

(2) risk factor levels,

(3) absolute CVD/CHD risk,

(4) the prescription of drugs,

(5) changes in health-related behaviour.

No

Unclear

Sheridan 2008 [17]

Whether knowledge of a global CHD risk scores translate into clinical benefits and whether there are any harms

Adults (> 18 years old) with no prior history of CVD

Providing physicians with global CVD risk scores or allowing them to calculate it themselves

No information about global CVD risk

(1) Improved physicians’ adherence to guidelines,

(2) increased appropriate prescribing,

(3) increased patient acceptance/ adherence to therapies,

(4) improved control of CVD risk factors,

(5) a reduction in CVD events.

Any adverse physical or psychosocial outcome

6 fair, 5 methodo-logically limited studies

Sheridan 2010 [18]

The effect of providing global CHD risk information to adults

Adults with no history of CVD

Global CHD risk presentation to the patient as the primary intervention or part of a multipart intervention

Not specified

(1) Accuracy of risk perception,

(2) intent to start treatment,

(3) adherence to therapy,

(4) change in predicted global risk or event rates,

(5) changes in patient BP, cholesterol levels, aspirin use, smoking cessation, diet or exercise.

No

6 good, 12 - fair quality studies

Waldron 2011 [35]

The effectiveness of different interventions used to communicate CVD risk and the impact of the formats used

Adults (> 18 years old), primary or secondary care

Risk communication interventions (of any format) for individualised cardiovascular risk assessment

Other interventions, or usual care.

Understanding, affect, intention to modify behaviour and reduction in actual risk

No

2 – good, 2 medium quality studies

van Dieren 2012 [36]

Impact assessment of a CVD risk model, scores or rules, applied to patients with type 2 diabetes.

(Also models development and validation studies)

People with type 2 diabetes and general population but included diabetes as a predictor

Risk assessment and format of its communication

Not specified

Not specified

No

Not reported

Willis 2012 [19]

The effectiveness of the use of CVD risk scores when combined with lifestyle interventions in the prevention of CVD

High risk patients, aged ≥40 and free from CVD

CVD risk assessment using validated risk scores followed by multifactorial interventions

Not specified

(1) CVD mortality,

(2) incidence of CV events,

(3) changes in a validated CVD risk score.

No

3 high, 1 moderate, 1 low quality study

Usher-Smith 2015 [37]

Whether the provision of information on CVD risk impacts decision-making, behaviour and patient health

Patients with no history of CVD

Provision of a CVD risk model estimate to either patients or practitioners

Other interventions, such as lifestyle

advice or exercise programmes

Risk perception; changes in: health-related behaviour, BP, cholesterol levels, modelled cardiovascular risk, medication prescribing, anxiety and psychological well-being, contact with healthcare professionals after provision of risk information

No

5 low; 1 low-medium; 7 medium; 3 medium-high; 1 high quality study

Tomasik 2017 [38]

The effects of global CVD risk estimation using the SCORE for preventing serious CVD events

Adults 40–65 years old; without CVD, diabetes or CKD; specific risk factors may have been presented; no preventive pharmacotherapy

CVD risk assessment using the SCORE model

Standard care, without total risk assessment

(1) Cardiovascular death,

(2) All-cause mortality,

(3) Atherosclerotic major events.

Any discomfort reported by patients; a decrease in the quality of life; adverse physical, psychological or social outcomes

–

Karmali 2017 [39]

The effects of evaluating and providing CVD risk scores on CVD outcomes, risk factor levels, medication prescribing, and health behaviours

Adults (≥18 years) in outpatient settings free of clinical CVD. Patients with diabetes, elevated risk factors, preventive medications eligible

Systematic provision of a CVD risk score by a clinician, healthcare professional, or healthcare system

Usual care (i.e. no systematic provision of a CVD risk score)

Primary: CVD events; changes in total cholesterol, LDL cholesterol, systolic BP, diastolic BP, multivariable CVD risk.

Secondary: preventive medication; medication adherence; smoking cessation; exercise; diet; decisional conflict; quality of life; costs.

Primary study investigator-defined adverse events e.g. physical or psychosocial events

overall low quality;

38 out of 41studies had high or unclear risk of bias

Collins 2017 [40]

Impact of global cardiovascular risk assessment in the primary prevention

Adults with no history of CVD

Interventions involving global CVD risk assessment

No formal risk assessment

Primary: CVD-related morbidity and mortality and all-cause mortality;

Secondary: SBP, cholesterol level, quitting smoking

No

1 low, 6 fair, 3 medium, 2 medium to high, 1 high, 3 good quality studies