Early diagnosis and risk estimation of cardiovascular diseases: Epidemiology, relevance, and comparative analysis of approaches in Russia, in the EU, and in the USA
Abstract. Cardiovascular diseases (CVDs) remain the leading cause of death, creating a significant socioeconomic burden for countries worldwide. Early diagnosis and risk assessment of CVDs are critical to reducing morbidity and mortality.Usanova A.A., Novikova E.K., Sergutova N.P., Kuzma F., Kunyaeva T.A., Fazlova I.Kh., Guranova N.N., Zhernakova N.I.
The aim of the current review is to compare all major approaches to early diagnosis and risk assessment of CVDs in Russia, in the European Union, and in the United States. It highlights current data on the epidemiology of CVDs, gender and age differences in their prevalence, associated economic costs, frequency of various diagnostic procedures, and the extent of screening. The efficacy of CVD diagnostic algorithms and the use of the Systematic Coronary Risk Evaluation 2 (SCORE2) and Atherosclerotic Cardiovascular Disease (ASCVD) prognostic risk scores are considered. Also cardiovascular mortality rates and screening coverage in rural and urban areas of Russia, in the European Union, and in the United States are presented. The conclusions from the article highlight the need to strengthen the prevention and diagnosis of CVDs, particularly in Russia.
Keywords
cardiovascular diseases
early diagnosis of cardiovascular diseases
cardiovascular risk assessment
cardiovascular epidemiologists
clinical examination
gender differences
SCORE2 scale
ASCVD scale
References
1. World Health Organization. Cardiovascular diseases (CVDs). 31 July 2025. URL: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (date of access – 18.11.2025).
2. Шляхто Е.В., Звартау Н.Э., Виллевальде С.В., Яковлев А.Н., Соловьева А.Е., Алиева А.С. с соавт. Система управления сердечно-сосудистыми рисками: предпосылки к созданию, принципы организации, таргетные группы. Российский кардиологический журнал. 2019;24(11):69–82. (Shlyakhto EV, Zvartau NE, Villevalde SV, Yakovlev AN, Soloveva AE, Alieva AS et al. Cardiovascular risk management system: Prerequisites for developing, organization principles, target groups. Rossiiskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2019;24(11):69–82 (In Russ.)).
EDN: YLFHXE. https://doi.org/10.15829/1560‑4071‑2019‑11‑69‑82
3. Kharlamov AN. Cardiovascular burden and percutaneous interventions in Russian Federation: Systematic epidemiological update. Cardiovasc Diagn Ther. 2017;7(1):60–84.
PMID: 28164014. PMCID: PMC5253445. https://doi.org/10.21037/cdt.2016.08.10
4 Драпкина О.М., Шальнова С.А., Имаева А.Э., Баланова Ю.А., Максимов С.А., Муромцева Г.А. с соавт. Эпидемиология сердечно-сосудистых заболеваний и их факторов риска в регионах Российской Федерации. Третье исследование (ЭССЕ-РФ-3). Обоснование и дизайн исследования. Кардиоваскулярная терапия и профилактика. 2022;21(5):48–57. (Drapkina OM, Shalnova SA, Imaeva AE, Balanova YuA, Maksimov SA, Muromtseva GA et al. Epidemiology of cardiovascular diseases in regions of Russian Federation. Third survey (ESSE-RF-3). Rationale and study design. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2022;21(5): 48–57 (In Russ.)).
EDN: EZUGUW. https://doi.org/10.15829/1728-8800-2022-3246
5. Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Back M et al.; ESC National Cardiac Societies; ESC Scientific Document Group. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2022;42(34):3227–37.
PMID: 34458905. https://doi.org/10.1093/eurheartj/ehab484
6. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2022;140(11):e596–e646.
PMID: 30879355. PMCID: PMC7734661. https://doi.org/10.1161/CIR.0000000000000678
7. Luengo-Fernandez R, Little M, Gray A, Torbica A, Maggioni AP, Huculeci R et al. Cardiovascular disease burden due to productivity losses in European Society of Cardiology countries. Eur Heart J Qual Care Clin Outcomes. 2023;9(5):qcad031.
PMID: 37280170. PMCID: PMC10785594. https://doi.org/10.1093/ehjqcco/qcad031
8. Kazi DS, Elkind MSV, Deutsch A, Dowd WN, Heidenreich P, Khavjou O et al.; American Heart Association. Forecasting the economic burden of cardiovascular disease and stroke in the United States through 2050: A Presidential Advisory from the American Heart Association. Circulation. Circulation. 2024;150(4):e89–e101.
PMID: 38832515. https://doi.org/10.1161/CIR.0000000000001258
9. Концевая А.В., Муканеева Д.К., Игнатьева В.И., Анциферова А.А., Драпкина О.М. Экономика профилактики сердечно-сосудистых заболеваний в Российской Федерации. Российский кардиологический журнал. 2023;28(9):19–26. (Kontsevaya AV, Mukaneeva DK, Ignatieva VI, Antsiferova AA, Drapkina OM. Economics of cardiovascular prevention in the Russian Federation. Rossiiskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2023;28(9):19–26 (In Russ.)).
EDN: KNLBZO. https://doi.org/10.15829/1560-4071-2023-5521
10. Алекян Б.Г., Бойцов С.А., Маношкина Е.М., Кочергин Н.А., Ганюков В.И. Российские национальные результаты реваскуляризации миокарда при остром коронарном синдроме за 2023 год. Кардиология. 2024;64(11):76–83. (Alekyan BG, Boytsov SA, Manoshkina EM, Kochergin NA, Ganyukov VI. National results of revascularization for acute coronary syndrome in 2023. Kardiologiya = Cardiology. 2024;64(11):76–83 (In Russ.)).
EDN: IFHIWD. https://doi.org/10.18087/cardio.2024.11.n2733
11. Голухова Е.З., Милиевская Е.Б., Филатов А.Г., Семенов В.Ю., Прянишников В.В., Сергуладзе С.Ю. Аритмология – 2023. Нарушения ритма сердца и проводимости. М.: Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева Минздрава РФ (Москва). 2024; 212 с. (Golukhova EZ, Milievskaya EB, Filatov AG, Semenov VYu, Pryanishnikov VV, Serguladze SYu. Arrhythmology – 2023. Heart rhythm and conduction disorders. Moscow: National Medical Research Center for Cardiovascular Surgery named after A.N. Bakulev of the Ministry of Healthcare of Russia (Moscow). 2024; 212 pp. (In Russ.)).
EDN: AXQZYS. ISBN: 978-5-7982-0465-6.
12. Бойцов С.А., Погосова Н.В., Аншелес А.А., Бадтиева В.А., Балахонова Т.В., Барбараш О.Л. с соавт. Кардиоваскулярная профилактика 2022. Российские национальные рекомендации. Российский кардиологический журнал. 2023;28(5):119–249. (Boitsov SA, Pogosova NV, Ansheles AA, Badtieva VA, Balakhonova TV, Barbarash OL et al. Cardiovascular prevention 2022. Russian national guidelines. Rossiiskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2023;28(5):119–249 (In Russ.)).
EDN: EUDWYG. https://doi.org/10.15829/1560-4071-2023-5452
13. Чулков В.С., Гаврилова Е.С., Чулков Вл.С., Панкова Е.Д., Ленец Е.А., Ткаченко П.Е. Первичная профилактика сердечно-сосудистых заболеваний: акцент на коррекцию поведенческих факторов риска. Российский кардиологический журнал. 2021;26(S3):67–72. (Chulkov VS, Gavrilova ES, Chulkov VlS, Pankova ED, Lenets EA, Tkachenko PE. Primary prevention of cardiovascular disease: Focus on improving behavioral risk factors. Rossiiskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2021;26(S3):67–72 (In Russ.)).
EDN: YNAIWA. https://doi.org/10.15829/1560-4071-2021-4278
14. Artyukhov IP, Grinshtein YI, Petrova MM, Shabalin VV, Ruf RR. Prevalence of arterial hypertension in the Krasnoyarsk Krai (Siberia, Russia). BMC Cardiovasc Disord. 2017;17(1):138.
PMID: 286793. PMCID: PMC5497345. https://doi.org/10.1186/s12872-017-0559-5
PMID: 28549412. PMCID: PMC5446734. https://doi.org/10.1186/s12872-017-0559-5
15. Timmis A, Vardas P, Townsend N, Torbica A, Katus H, De Smedt D et al.; Atlas Writing Group, European Society of Cardiology. European Society of Cardiology: Cardiovascular disease statistics 2021. Eur Heart J. 2022;43(8):716–99.
PMID: 35016208. https://doi.org/10.1093/eurheartj/ehab892
16. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL et al.; ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315–81.
PMID: 27222591. PMCID: PMC4986030. https://doi.org/10.1093/eurheartj/ehw106
17. Rossello X, Dorresteijn JA, Janssen A, Lambrinou E, Scherrenberg M, Bonnefoy-Cudraz E et al.; This Paper Is A Co-Publication Between European Journal Of Preventive Cardiology European Heart Journal Acute Cardiovascular Care And European Journal Of Cardiovascular Nursing. Risk prediction tools in cardiovascular disease prevention: A report from the ESC Prevention of CVD Programme led by the European Association of Preventive Cardiology (EAPC) in collaboration with the Acute Cardiovascular Care Association (ACCA) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP). Eur J Prev Cardiol. 2019;26(14):1534–44.
PMID: 31234648. https://doi.org/10.1177/2047487319844126
18. Eurostat. Cardiovascular diseases statistics. 2024. URL: https://ec.europa.eu/eurostat/statistics-explained/index.php/Cardiovascular_diseases_statistics (date of access – 18.11.2025).
19. Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS et al. Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Circulation. 2022;145(8):e153–e639.
PMID: 35078371. https://doi.org/10.1161/CIR.0000000000001052
20. Lloyd-Jones DM, Huffman MD, Karmali KN, Sanghavi DM, Wright JS, Pelser C et al. Estimating longitudinal risks and benefits from cardiovascular preventive therapies among medicare patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A special report from the American Heart Association and American College of Cardiology. Circulation. 2017;135(13):e793–e813.
PMID: 27815375. PMCID: PMC6027623. https://doi.org/10.1161/CIR.0000000000000467
21. Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR et al. Genetic risk, adherence to a healthy lifestyle, and coronary disease. N Engl J Med. 2016;375(24):2349–58.
PMID: 27959714. PMCID: PMC5338864. https://doi.org/10.1056/NEJMoa1605086
22. Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB Sr, Gibbons R et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2935–59.
PMID: 24239921. PMCID: PMC4700825. https://doi.org/10.1016/j.jacc.2013.11.005
23. Sekkarie A, Woodruff RC, Casper M, Paul AT, Vaughan AS. Rural-urban disparities in cardiovascular mortality by poverty level and region in the US. J Rural Health. 2025;37(1):37–41.
PMID: 39152622. https://doi.org/10.1111/jrh.12874
24. Wenger NK, Lloyd-Jones DM, Elkind MSV, Fonarow GC, Warner JJ, Alger HM et al.; American Heart Association. Call to action for cardiovascular disease in women: Epidemiology, awareness, access, and delivery of equitable health care: A presidential advisory from the American Heart Association. Circulation. 2022;145(23):1059–71.
PMID: 35531777. PMCID: PMC10162504. https://doi.org/10.1161/CIR.0000000000001071
25. Приказ Минздрава РФ № 404н от 27.04.2021 «Об утверждении Порядка проведения профилактического медицинского осмотра и диспансеризации определенных групп взрослого населения». Доступ: http://publication.pravo.gov.ru/Document/View/0001202106300043 (дата обращения – 18.11.2025). (Order of the Ministry of Healthcare of Russia No. 404n dated 04/27/2021 “On approval of the Procedure for conducting preventive medical examination and medical examination of certain groups of the adult population”. URL: http://publication.pravo.gov.ru/Document/View/0001202106300043 (date of access – 18.11.2025) (In Russ.).)
26. SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: New models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42(25):2439–54.
PMID: 34120177. PMCID: PMC8248998. https://doi.org/10.1093/eurheartj/ehab309
27. Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: The Reynolds Risk Score. JAMA. 2007;297(6):611–19.
PMID: 17299196. https://doi.org/10.1001/jama.297.6.611
28. Карайланов М.Г., Ужох-Бажноков О.А., Моисеева К.Е., Алексеева А.В., Дайнеко М.Ю., Горланов И.А. Основные направления улучшения диспансерного наблюдения за пациентами с применением цифровых технологий. Медицина и организация здравоохранения. 2024;9(1):136–150. (Karailanov MG, Uzhokh-Bazhnokov OA, Moiseeva KE, Alekseeva AV, Daineko MYu, Gorlanov IA. The main directions of improving dispensary monitoring of patients using digital technologies. Meditsina i organizatsiya zdravookhraneniya = Medicine and Health Care Organization. 2024;9(1):136–150 (In Russ.)).
EDN: TUNQBH. https://doi.org/10.56871/MHCO.2024.40.98.011
29. van Daalen KR, Zhang D, Kaptoge S, Paige E, Di Angelantonio E, Pennells L. Risk estimation for the primary prevention of cardiovascular disease. Lancet Glob Health. 2024;12(8):1343–58.
PMID: 39030064. PMCID: PMC11283887. https://doi.org/10.1016/S2214-109X(24)00210-9
About the Authors
Anna A. Usanova, MD, Dr. Sci. (Medicine), professor, head of the Department of faculty therapy with a course in medical rehabilitation, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.E-mail: anna61-u@mail.ru
ORCID: https://orcid.org/0000-0003-2948-4865. eLibrary SPIN: 8346-6031
Elvira K. Novikova, MD, assistant at the Department of faculty therapy with a course in medical rehabilitation, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.
E-mail: Elja_F@mail.ru
ORCID: https://orcid.org/0000-0002-2839-8984
Natalya P. Sergutova, MD, PhD (Medicine), associate professor of the Department of faculty therapy with a course in medical rehabilitation, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.
E-mail: sergutovanp@mail.ru
ORCID: https://orcid.org/0000-0001-8274-7906. eLibrary SPIN:1960-1330
Fady Kuzma, MD, PhD (Medicine), senior lecturer of the Department of faculty therapy with a course in medical rehabilitation, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.
E-mail: fadykuzma@mail.ru
ORCID: https://orcid.org/0000-0002-5215-0196
Tatyana A. Kunyaeva, MD, PhD (Medicine), associate professor of the Department of outpatient therapy, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.
E-mail: kunya_eva@mail.ru
ORCID: https://orcid.org/0000-0003-4245-4265. eLibrary SPIN: 9245-0700
Irina Kh. Fazlova, MD, PhD (Medicine), associate professor of the Department of faculty therapy with a course in medical rehabilitation, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.
E-mail: fazlova@inbox.tu
ORCID: https://orcid.org/0000-0003-7082-6818. eLibrary SPIN:1719-2381
Natalya N. Guranova, MD, PhD (Medicine), associate professor of the Department of faculty therapy with a course in medical rehabilitation, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68/1 Bolshevistskaya St.
E-mail: nguranova@mail.ru
ORCID: https://orcid.org/0000-0003-2819-0478. eLibrary SPIN:9125-1227
Nina I. Zhernakova, MD, Dr. Sci. (Medicine), professor, head of the Department of family medicine, Belgorod State National Research University. Address: 308015, Belgorod, 85 Pobedy St.
E-mail: zhernakova@bsuedu.ru
ORCID: https://orcid.org/0000-0001-7648-0774. eLibrary SPIN:6858-8259
Similar Articles
