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Fundamentals of risk stratification The risk assessment is based on the Integration of multiple factors, which can be divided into two main groups: Modifiable Risk Factors: Hypertension (blood pressure≥140/90 mmHg); Dyslipidemia (elevated LDL cholesterol, low HDL‑cholesterol values); Tobacco consumption (active and passive Smoking); Diabetes mellitus (elevated HbA 1c ); Overweight and obesity (BMI ≥25 kg/m 2 ); physical inactivity; unhealthy diet (high in salt, sugar and TRANS fat consumption). Non-modifiable risk factors: Age (men ≥45 years, women ≥55 years of age or after Menopause); Gender (higher risk in men, in younger age groups); family history of early CVD (incidents in first-degree Relatives: men, 55 years for women and 65 years ago). Instruments for risk estimation For the standardized risk assessment, different Scores are used: SCORE System (Systematic COronary Risk Evaluation): The 10‑year calculated risk for a fatal cardiovascular events on the Basis of age, gender, blood pressure, cholesterol and Smoking status. Framingham‑Risk Core: Determines 10‑year risk for coronary heart disease with the involvement of similar parameters. ASCVD risk calculator (Atherosclerotic Cardiovascular Disease): It is used mainly in the United States and taken into account in addition to HDL‑cholesterol. Stages of risk stratification On the basis of the calculated risk patients are divided values into the following categories: Low Risk: &lt;1,0% (SCORE) — Health information and lifestyle advice. Moderate risk: 1,0–4,9% — more and better advice, if necessary, drug Intervention in the case of individual factors (e.g., hypertension). The high-risk range: 5.0–9.9% of the combined preventive strategies, medications for blood pressure and lipid-lowering. Very high risk: ≥10.0% or existing CVD — aggressive risk factor reduction, intensive Monitoring. Current developments and extensions In addition to the conventional Scores of additional markers will be discussed to improve the risk stratification: Coronary calcium Scoring (CAC Score) by means of CT; Measurement of high-sensitive C‑reactive Protein (hs‑CRP); Family history on the second-degree line; genetic-risk profiles. Conclusion The evidence-based stratification of cardiovascular risk allows for a differentiated prevention strategy. Through the identification of high-risk persons, the incidence of coronary heart can be reduced events significantly. The continuous development of risk models, and the Integration of new biomarkers will improve the precision of risk assessment in the future. 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