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Absolute risk of cardiovascular disease events, and blood pressure- and lipid-lowering therapy in Australia

Med J Aust 2016; 204 (8): 320. || doi: 10.5694/mja15.01004

Summary

Objective: To quantify absolute cardiovascular disease (CVD) risk and treatment in Australian adults.

Design, participants: Cross-sectional representative study of 9564 people aged 18 years or more who had participated in the 2011–12 Australian National Health Measures Survey (response rate for those aged 45–74 years: 46.5%).

Main outcome measures: Prior CVD was ascertained and 5-year absolute risk of a primary CVD event calculated (using the Australian National Vascular Disease Prevention Alliance algorithm; categories: low [< 10%], moderate [10–15%], and high [> 15%] risk) on the basis of data on medical history, risk factors and medications, derived from interviews, physical measurements, and blood and urine samples.

Results: Absolute CVD risk increased with age and was higher among men than women. Overall, 19.9% (95% CI, 18.5–21.3%) of Australians aged 45–74 years had a high absolute risk of a future CVD event (an estimated 1 445 000 people): 8.7% (95% CI, 7.8–9.6%) had prior CVD (estimated 634 000 people) and 11.2% (95% CI, 10.2–12.2%) had high primary CVD risk (estimated 811 000 people). A further 8.6% (95% CI, 7.4–9.8%, estimated 625 000) were at moderate primary CVD risk. Among those with prior CVD, 44.2% (95% CI, 36.8–51.6%) were receiving blood pressure- and lipid-lowering medications, 35.4% (95% CI, 27.8–43.0%) were receiving only one of these, and 20.4% (95% CI, 13.9–26.9%) were receiving neither. Corresponding figures for high primary CVD risk were 24.3% (95% CI, 18.3–30.3%); 28.7% (95% CI, 22.7–34.7%); and 47.1% (95% CI, 39.9–54.3%).

Conclusions: About one-fifth of the Australian population aged 45–74 years (about 1.4 million individuals) were estimated to have a high absolute risk of a future CVD event. Most (estimated 970 000) were not receiving currently recommended combination blood pressure- and lipid-lowering therapy, indicating substantial potential for health gains by increasing routine assessment and treatment according to absolute CVD risk.

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  • Emily Banks1,2
  • Simon R Crouch3
  • Rosemary J Korda1
  • Bill Stavreski4
  • Karen Page5
  • Katherine A Thurber1
  • Robert Grenfell1

  • 1 National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
  • 2 Sax Institute, Sydney, NSW
  • 3 Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC
  • 4 National Heart Foundation of Australia, Melbourne, VIC
  • 5 Deakin University, Melbourne, VIC

Correspondence: emily.banks@anu.edu.au

Acknowledgements: 

This project was conducted in partnership with the National Heart Foundation of Australia, with support from a National Health and Medical Research Council of Australia (NHMRC) Partnership Project (reference 1092674) and the NHMRC Centre for Research Excellence in Medicines and Ageing (reference 1060407). Emily Banks is supported by the NHMRC (reference 1042717).

Competing interests:

Robert Grenfell, Simon Crouch and Karen Page were employees of the National Heart Foundation of Australia at the time of analysis and writing, and participated fully as authors, independently of the funding division of the organisation. The funding sources thus had no role in the study design; collection, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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