Cardiovascular disease (CVD) is the leading cause of death in Australia and elsewhere, accounting for 17% of all deaths in Australia in 2006.1 The traditional approach to primary prevention has been to identify at risk individuals through individual risk factors, for example ‘hypertension’ and ‘hypercholesterolaemia’. There are positive associations between the level of these individual risk factors and adverse cardiovascular events.2 There also are effective therapies that have been shown to decrease these risk factors and the subsequent number of major adverse cardiovascular events (MACE). For example, antihypertensive drugs and statins have been shown to not only reduce blood pressure and total cholesterol respectively, but also to reduce the risk of MACE such as heart failure and stroke.3,4
This study was designed to investigate
general practitioners’ knowledge of
absolute risk estimation, and whether
they used it to guide their management
of cardiovascular disease.
A cross sectional postal self
administered survey of GPs in the
General Practice South Division in
A total of 56–62% of responders correctly
answered knowledge questions, which
could be as low as 33–36% when
corrected for nonresponse bias. A
cardiovascular risk calculator was used
by 72% (as low as 42% when corrected
for nonresponse bias); of these, 93%
used them to motivate lifestyle change
and for education, and 66% used them
to assist disease management. General
practitioners who used risk calculators
tended to rate some factors more highly
as contributing to cardiovascular disease,
such as Aboriginality and diabetes.
Many GPs were using absolute risk
calculators, and most used them
appropriately as decision making tools,
not just for education or motivation.
Further education of GPs about
cardiovascular risk is still indicated.
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