Sleep

May 2009

Research

Cardiovascular risk assessment in Australian general practice

Volume 38, No.5, May 2009 Pages 364-368

Ruchi Gupta

Nigel Stocks

Jessica Broadbent

Background

Australian general practitioners are encouraged to assess absolute cardiovascular risk (CVR) using a CVR calculator such as the New Zealand Cardiovascular Risk Calculator. However, overseas research suggests that the use of these tools is problematic. Australian data on CVR calculator use is lacking.

Methods

A self administered postal questionnaire exploring GP attitudes toward CVR assessment and management was sent to a random sample of a quarter of South Australian GPs. These GPs were also asked to estimate the absolute CVR for six clinical case scenarios and to provide an outline of their proposed management plan.

Results

Most GPs surveyed (63%) used a CVR calculator. In their responses, they said they felt successful at managing patients with medical risk factors that could be treated with medication; when it came to their ability to influence lifestyle risk factors however, they were generally pessimistic. Absolute CVR was more likely to be under- or over-estimated by GPs surveyed than estimated correctly. But when asked to prioritise their management strategies, GPs mainly favoured interventions that could result in meaningful reductions in CVR factors.

Discussion

A better understanding is needed of how to incorporate CVR calculations into every day clinical practice in a way that both estimates risk accurately and engages and educates patients. Ongoing research into effective GP led interventions that can assist patients to reduce lifestyle risk factors is needed.

Although age standardised deaths from cardiovascular disease (CVD) have been falling since the 1960s, CVD remained the largest single cause of death in Australia in 2002.1 Annual expenditure on cardiovascular drugs between October 2003 and September 2004 under the Pharmaceutical Benefits Scheme (PBS) was $1.6 billion, with $880 million spent on statins alone.2

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Correspondence afp@racgp.org.au

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For more information see Wikipedia: Comparison of reference management software