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.
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.
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
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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