Cardiovascular risk calculators estimate the likelihood of developing cardiovascular disease. They use factors such as age, cholesterol, blood pressure, smoking and diabetes.
But an estimated risk is a probability. It does not directly show whether atherosclerosis is already present in the arteries.
The Miami Heart Study demonstrated this distinction in people with diabetes.
Researchers examined adults who had no cardiovascular symptoms. Among participants with diabetes whose estimated 10-year cardiovascular risk was below 5%, 46% already had plaque in the arteries supplying the heart.
Significant narrowing of a coronary artery was found in 10%.
This does not mean that cardiovascular risk calculators are inaccurate or unhelpful. They provide important information about future risk.
But estimated risk and existing atherosclerosis are not identical measures. One estimates the probability of future cardiovascular events. The other describes disease that is already present.
For some people with diabetes, this distinction may be important when planning an individualized cardiovascular assessment.
