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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
Adults aged ≥45 years not known to have cardiovascular disease (CVD) or not clinically determined to be at high risk
Calculate absolute CVD risk* 45–74 years (II, B) 34
Every two years†
Aboriginal and Torres Strait Islander peoples aged ≥35 years not known to have CVD or not clinically determined to be at high risk
Assess absolute CVD risk (may underestimate risk; IV, C)
Every two years
*Calculate risk using the National Heart Foundation of Australia’s risk charts (refer to Appendix 8A. Australian cardiovascular disease risk charts in the PDF versikon).
Blood lipid results within five years can be used in the calculation of absolute CVD risk, but blood pressure (BP) should be measured at the time of assessment.
On-therapy measures of BP and cholesterol may underestimate absolute risk, and thus, recently recorded pre-treatment measures may be more appropriate to use if available. An electrocardiogram (ECG) is not required to determine left ventricular hypertrophy (LVH) if it is not previously known. Other absolute CVD risk calculators have been developed but most should not be applied to the Australian population.
†Adults with any of the following do not require absolute CVD risk assessment using the absolute risk calculator, because they are already known to be at clinically determined high risk of CVD (IV, D):
BP, blood pressure; CKD, chronic kidney disease; CVD, cardiovascular disease; DBP, diastolic blood pressure; ECG, electrocardiogram; eGFR, estimated glomerular filtration rate; FH, familial hypercholesterolaemia; LVH, left ventricular hypertrophy; SBP, systolic blood pressure; UACR, urine albumin-to-creatinine ratio
Guidelines for preventive activities in general practice 9th Edition (PDF 3MB)
Lifecyle Charts (PDF 70KB)
Appendix 2A - Family history screening questionnaire (PDF 35KB)
Appendix 2B -Dutch Lipid Clinic Network Criteria for making a diagnosis of familial hypercholestrolaemia in adults (PDF 40KB)
Appendix 3A - 'Red-flag' early intervention referral guide (PDF 379KB)
Appendix 8A - Australian cardiovascular disease risk charts (PDF 405KB)
Appendix 13A - The 3 Incontinence Questions 3IQ (PDF38KB)