Risk estimates are based on information from the general population, and the accuracy of these models has not been adequately evaluated in patients with rheumatoid arthritis (RA). In their report, Crowson et al elegantly demonstrate that well-established cardiovascular risk score calculators, such as the Framingham score and Reynolds score, underestimate the true cardiovascular risk in patients with RA. We concur that the differences between observed and predicted cardiovascular risk in patients with RA may be due either to differential effects or associations of traditional cardiovascular risk factors with outcomes or to other nontraditional—perhaps in particular RA disease-related characteristic—risk factors. Because traditional cardiovascular risk factors are already included in existing cardiovascular risk score models, it is important to identify other factors associated with increased cardiovascular risk in RA. We recently summarized and evaluated currently available publications according to the European League Against Rheumatism’s standardized operating procedures, to provide evidence-based European League Against Rheumatism recommendations for cardiovascular risk management in patients with RA. In that report, we identified 3 prognostic cardiovascular disease markers: disease duration >10 years, rheumatoid factor and/or anti–cyclic citrullinated peptide positivity, and severe disease (e.g., patients with extra-articular manifestations). Therefore, we recommended adapting existing risk score models by introducing a multiplication factor of 1.5 when patients with RA meet ≥2 of the aforementioned criteria. We acknowledge that our recommendation regarding a multiplication factor of 1.5 is potentially debatable, because there is a scarcity of prospective cohorts to enable the more usual approach in defining multiplication factors. Crowson et al demonstrate that cardiovascular disease risk appears most pronounced in patients with RA with rheumatoid factor positivity, older age (in keeping with longer disease duration), and severe disease, the latter indicated by a persistently elevated erythrocyte sedimentation rate. Hence, the investigators are well placed also to assess the accuracy of the European League Against Rheumatism recommendations.