Definition Of Risk Stratification

When using the term 'risk stratification', it becomes apparent that for CR professionals the concept is very different from that used by those concerned with the medical management of CHD patients. In medical practice the physician or health practitioner considers quantifying the risk of CHD for an individual either in terms of absolute or relative risk. Absolute risk relates to a specific 'risky behaviour' where statistics define the risk within a population. Relative risk relates risk to an individual and compares that person's risk within a specific group, i.e. same age/gender and expresses this as a ratio (Lindsay, 2004).

Both approaches are useful predictors in the primary care (PC) setting for CHD prevention and effective medical management. In secondary prevention (SP), the physician or health practitioner deliberates the likelihood of recurrent cardiac events in relation to disease prognosis and progression. Ultimately this determines ongoing medical intervention.

The purpose of risk stratification in CHD medical management, therefore, is to identify those most at risk of developing CHD and/or from subsequent cardiac events in order to instigate optimum medical management. In the CR setting, however, the aim is to attempt to predict those at risk of exercise-related cardiac incidents and to tailor exercise prescription, supervision and monitoring appropriately to the individual.

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