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Prevention of vascular and metabolic disease

Assessment of absolute cardiovascular risk

Guidelines for preventive activities in general practice
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Absolute CVD risk assessment combines risk factors to calculate the probability that an individual will develop a cardiovascular event (eg myocardial infarction, stroke) or other vascular disease within a specified time frame (usually five years). Absolute CVD risk assessment should be conducted at least every two years in all adults aged >45 years who are not known to have CVD or to be at clinically determined high risk (B).34 This calculation requires information on the patient’s age, sex, smoking status, total and high-density lipoprotein-cholesterol (HDL–C), systolic blood pressure (SBP) and whether the patient is known to have diabetes or left ventricular hypertrophy (LVH). In adults at low absolute CVD risk, blood test results within five years may be used for review of absolute CVD risk unless there are reasons to the contrary.34

Adults >74 years of age may have their absolute CVD risk assessed with age entered as 74 years. This is likely to underestimate five-year risk but will give an estimate of minimum risk.35 Patients with a family history of premature CVD (in a first-degree relative – men aged <55 years, women aged <65 years)4 or obesity (body mass index [BMI] above 30 kg/m2 or more) may be at greater risk.36–38 Similarly, patients with depression and atrial fibrillation (AF) may also be at increased risk.34

Table 8.1.1

Table 8.1.1

Cardiovascular disease: Identifying risk
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