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Premature coronary artery disease and arterial stiffness: too soon to speculate?
  1. Nicholas L Cruden
  1. Edinburgh Heart Centre, New Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Nicholas L Cruden, Edinburgh Heart Centre, New Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 5SA, UK; nick.cruden{at}ed.ac.uk

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Predicting the future is challenging and cardiovascular risk is no exception. Absolute values of individual risk factors such as blood pressure or cholesterol correlate poorly with an individual's risk of developing symptomatic cardiovascular disease.1 As a result, complex algorithms have emerged in an effort to more accurately characterise an individual's cardiovascular risk.2 3

Age is a major determinant of cardiovascular risk in existing models so it is perhaps not surprising that, when additional risk factors are present, cardiovascular risk in younger people may be significantly underestimated.4 This limitation is particularly relevant to people with a family history of premature coronary artery disease5 because not all first-degree relatives may inherit the genetic trait that predisposes them to cardiovascular disease. Accurately determining cardiovascular risk in these people is paramount if risk reduction strategies are to be targeted appropriately.1 The routine use of non-invasive markers of underlying vascular disease such as arterial stiffness may extend the prognostic value of existing screening algorithms.

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