Cancer Screening

April 2009


Heart health

CHD management gaps in general practice

Volume 38, No.4, April 2009 Pages 241-245

Nancy Huang

Marcus Daddo

Eleanor Clune


For many years, the Heart Foundation has been involved in the development of evidence based clinical practice guidelines for the management of cardiovascular diseases and conditions, including coronary heart disease (CHD). However, the production of guidelines does not ensure the uptake of evidence based recommendations in practice. This ‘management gap’ – or difference between guideline recommendations and actual clinical practice – may contribute significantly to the burden of CHD in Australia.


This review aims to identify gaps of clinical significance in the management of CHD in Australian general practice. These identified gaps will then inform future efforts to improve cardiovascular outcomes in this setting.


A literature and key documents search was undertaken to identify Australian data relating to cardiovascular disease, current practice and treatment gaps in the general practice setting. A number of gaps in the management of CHD exist in Australia. Addressing these gaps will improve patient outcomes. While the reasons for the management gaps are complex and multifaceted, the Heart Foundation will use this information to focus its messages and activities in general practice. The key messages developed present opportunities for improved clinical management of CHD in general practice.

Coronary heart disease (CHD) represents a major health burden in Australia, affecting an estimated 334 500 Australians1 and claiming nearly 23 000 Australian lives in 2006.2 In addition, many more Australians are at risk of CHD, with 90% of adults (about 13.1 million people) in Australia having at least one modifiable risk factor and one in 4 people having three or more.3 The prevalence of individual risk factors is high, and unfavourable trends have been observed with insufficient physical activity, excess weight and diabetes over the past 20 years.3

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