NVDPA Summary of Practice Points
| a | In adults without known cardiovascular disease, a comprehensive assessment of cardiovascular risk includes consideration of the following: Modifiable risk factors smoking status blood pressure serum lipids waist circumference and body mass index nutrition physical activity level alcohol intake* Non-modifiable risk factors age and sex family history of premature cardiovascular disease social history including cultural identity, ethnicity, socioeconomic status and mental health Related conditions diabetes renal function (microalbumin ± urine protein, estimate of glomerular filtration rate) familial hypercholesterolaemia evidence of atrial fibrillation (history, examination, electrocardiogram) |
| b | For adults at high risk of cardiovascular disease, identifying all cardiovascular risk factors present enables investigation and intensive management by lifestyle interventions (all patients) and pharmacological interventions (where indicated). |
| c | A comprehensive assessment of cardiovascular risk involves consideration of socioeconomic deprivation, because it is an independent risk factor for cardiovascular disease. Absolute risk of cardiovascular disease calculated using the Framingham Risk Equation is likely to underestimate cardiovascular risk in socioeconomically deprived groups.† |
| d | In adults with atrial fibrillation (particularly those aged over 65 years), the increased risk† of cardiovascular events and all-cause mortality, in addition to thromboembolic disease and stroke, should be taken into account when assessing absolute cardiovascular risk. |
| e | The following qualitative risk categories can be used to describe calculated absolute cardiovascular risk: "Low" risk corresponds to less than 10% probability of cardiovascular disease within the next 5 years "Moderate" risk corresponds to 10–15% risk of cardiovascular disease within the next 5 years "High" risk corresponds to greater than 15% risk of cardiovascular disease within the next 5 years. |
| f | Regular review of absolute cardiovascular risk is recommended at intervals according to initial assessed risk level: Low – review every 2 years Moderate – review every 6–12 months High – review according to clinical context. |
Ұ These practice points were developed to facilitate clinical uptake of these guidelines by GPs and other target users.
* Alcohol is a risk factor for elevated blood pressure (which is itself a major independent determinant of risk of atherosclerotic disease), stroke and cardiomyopathy. For a full discussion of this, please refer to the draft 2007 NHMRC Alcohol Guidelines (Public Consultation document).
† While CVD risk is known to be elevated for this population, it is not possible to quantify the degree of additional CVD risk in an individual. Clinical judgement is necessary when assessing an individual's overall CVD risk.