Noninvasive assessment of cardiovascular risk: from Framingham to the future.

Risk assessment and risk factor modification have become essential tools in the management of cardiovascular disease. While the risk assessment defined by the Framingham Study researchers was a great leap forward, the search for additional and more precise markers of cardiovascular risk continues. Markers of thrombosis, abnormal endothelial function, plaque formation, and other events in atherosclerosis development are being evaluated. Some of the most promising for population screening are high-sensitivity C-reactive protein tests, degree of arterial stiffness (measured directly or as pulse pressure), and ankle-brachial index.