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Prioritising CVD prevention therapy - absolute risk versus individual risk factors

Jenny Doust1, Sharon Sanders, Jonathan Shaw

  • 1Centre for Research in Evidence Based Practice, Bond University, Gold Coast, Queensland, Australia. jdoust@bond.edu.au

Australian Family Physician
|December 5, 2012
PubMed

Insights

An absolute risk approach for cardiovascular disease prevention in Australia prioritizes treatment for high-risk individuals, but clarity on its definition is needed. This method identifies fewer patients for blood pressure and lipid-lowering therapy compared to individual risk factors.

Area of Science:

  • Cardiology
  • Public Health
  • Preventive Medicine

Background:

  • High-risk individuals in Australia often lack adequate cardiovascular disease prevention, including blood pressure and lipid-lowering therapies.
  • The impact of shifting from individual risk factors to an absolute risk approach on treatment rates remains unclear.

Purpose of the Study:

  • To compare the proportion of untreated individuals recommended for blood pressure and lipid-lowering therapy using individual risk factor assessment versus an absolute risk approach.
  • To evaluate the implications of adopting an absolute risk model for cardiovascular disease prevention strategies in Australia.

Main Methods:

  • Analysis of participants from the AusDiab follow-up cohort study with no prior cardiovascular disease or current medication.
  • Classification of participants based on individual risk factors (elevated blood pressure, dyslipidemia) versus combined absolute risk assessment.

Main Results:

  • Among 3627 untreated participants, 12% had elevated blood pressure and 27% had dyslipidemia; 5% had both.
  • Individual risk factor approaches would lead to treatment for 34% of participants, while the absolute risk approach identified only 8% as high-risk.

Conclusions:

  • An absolute risk approach effectively prioritizes treatment for the highest-risk individuals.
  • Ambiguities persist regarding the precise definition and application of the absolute risk approach in clinical practice.
Abstract

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