Adapted with permission from Dr. D. Drouin and Dr. G. Tremblay, 2001.

Recent studies suggest that there is a continuum of risk. Everyone falls into the risk continuum, which is divided into four categories: low, medium, high, and very high or "hyper-risk." The clinical conditions of this continuum are placed in the following order:
Asymptomatic, Asymptomatic with risk factors, Diabetic – Cardiovascular disease, Diabetic with risk factors, Multi-vascular disease, Unstable CAD

Note that the risk level goes from low-risk to hyper-risk. A coronary patient with an unstable angina condition is an example of a hyper-risk candidate. We also note that the risk associated with diabetes places this disease at the same risk level as symptomatic cardiovascular disease. It is now general knowledge (since the publication of the HOPE study results) that a diabetic with cardiovascular disease is at risk of a post-infarction.

Lastly, the chart illustrates that primary physicians provide most of the medical care administered to the population who is between low and medium risk, while medical specialists treat people who are at high risk. In order to provide optimal care, there should be cooperation and communication between specialists and general/family practitioners (i.e., an overlap of first- and second-line treatment).