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Guidelines for preventive activities in general practice 7th edition

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Full index

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Oral hygiene

Glaucoma

Urinary incontinence

Osteoporosis

Screening tests of unproven benefit

References

Appendices

Glossary

Acronyms

Acknowledgements

Disclaimer

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Cholesterol and lipids

Cholesterol and lipids age range table
Age 0 - 9 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 79 >80
                  X X X X X X X

Screening of healthy people without other risk factors is recommended every 5 years starting at 45 years of age (A for men, C for women). High risk patients should be screened as part of absolute cardiovascular risk assessment (A).

Cholesterol and lipids: Risk
Who is at higher risk of vascular disease? What should be done? How often? Level of evidence and references

Increased risk

  • Patients 45 years of age and over
Fasting blood lipids
Every 5 years
I A 318

Increased risk

  • Patients aged 45 years and over with:
    • absolute CV risk 10–15% over the next 5 years
    • smoking
    • hypertension
    • metabolic syndrome (central obesity waist =94 cm in men and =80 cm in women plus any two of: TG >1.7 mmol/L, HDL-C <1.03 mmol/L in men and <1.29 mmol/L in women, BP =130/85 mmHg or fasting BSL =5.6 mmol/L)
    • family history of premature CVD in first degree relatives (<60 years of age


Fasting blood lipids

Lifestyle advice
Every 2 years
I A 318
High risk
  • Patients with an absolute CV risk >15% over the next 5 years
  • Patients with the following existing diagnoses:
    • diabetes mellitus (type 1 and 2) or impaired glucose tolerance
    • cardiac disease, peripheral arterial disease or ischaemic cerebrovascular disease (including stroke)
    • familial hypercholesterolaemia or familial combined hyperlipidaemia
    • chronic kidney diseas


Fasting blood lipids

Lifestyle advice

Cholesterol lowering therapy
Every 12 months
I A 318

Cholesterol and lipids intervention
Intervention Technique References
Fasting blood lipids Fasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. If total cholesterol (TC) is raised (>4 mmol/L) or LDL >2.5 mmol/L, a second confirmatory sample should be taken on a separate occasion (as levels may vary between tests) before a definitive diagnosis is made 318
Dietary advice All people regardless of their cholesterol level should be given dietary advice. In patients whose cholesterol is raised, absolute cardiovascular risk should be determined (see Page 91). Those at low absolute risk of CVD should be given dietary and other lifestyle advice and monitored. See Section 6 Prevention of chronic disease 318

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© The Royal Australian College of General Practitioners
Printed from www.racgp.org.au/redbook