TTRUE GP Network
Part of a Centre for Research Excellence at
Bond University and The University of Sydney
evidence based practice + shared decision making
CARDIOVASCULAR DISEASE PREVENTION
Here you will find the latest research evidence and decision making tools for cardiovascular disease prevention, including absolute risk assessment and when to focus on:
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lifestyle management
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preventive medication
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surgery
Follow the links below to find evidence summaries and decision making tools for this topic
Patient characteristics that indicate high risk of a cardiovascular event (e.g. heart attack or stroke):
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Diabetes and age >60 years
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Diabetes with microalbuminuria (>20 mcg/min or urinary albumin:creatinine ratio >2.5 mg/mmol for males, >3.5
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mg/mmol for females)
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Moderate or severe CKD (persistent proteinuria or estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2)
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A previous diagnosis of familial hypercholesterolaemia
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Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg
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Serum total cholesterol >7.5 mmol/L
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Aboriginal and Torres Strait Islander adults aged over 74 (CBR)
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Absolute risk assessment indicates >15% risk of a CVD event in the next 5 years
PATIENT CHARACTERISTICS
RISK ASSESSMENT
CONSULTATION DECISION MAKING
Topics to discuss in consultations:
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Primary prevention/screening options appropriate to risk
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Secondary prevention/screening options appropriate to risk
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Patient preferences
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Relevant Decision Aids offered
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Goal setting and finalise plan
Decision Aids for managing lifestyle risk factors:
Decision Aids for managing CVD risk factors:
Risk assessment for stratification of risk level:
For patients with no history of cardiovascular disease who are not currently on preventive CVD medication:
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Australian absolute risk calculator: absolute risk of heart attack/stroke over next 5 years (Framingham model)
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New Zealand risk calculator: absolute risk of heart attack/stroke over next 5 years + heart age assessment (Framingham model)
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JBS3 Risk Calculator: QRISK2 + heart age (10 yr)
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2013 Prevention Guidelines ASCVD Risk Estimator: ACC/AHA (10 yr)
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Comparison of Different Models: absolute risk of CVD event over next 10 years (Framingham, QRISK and US models)
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Rate the Risk Assessments here.
Initial considerations for risk assessment:
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Demographics, including age, gender, Aboriginal and Torres Strait Islander ethnicity
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Possibly Health Literacy/Social and Cultural Context
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Lifestyle factors, including smoking, diet and exercise
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Family History of cardiovascular disease, particularly at a young age
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Past history of cardiovascular disease
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Related conditions: diabetes, chronic kidney disease (albuminuria ± urine protein, eGFR), familial hypercholesterolaemia, evidence of atrial fibrillation (history, examination, electrocardiogram)
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Symptoms
Risk Assessment And Management Algorithm Adults Aged 45 Years And Over Without Known History Of CVD:
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