Primary prevention of cardiovascular disease: new guidelines, technologies and therapies

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Primary prevention of cardiovascular disease (CVD) is shifting from managing isolated risk factors to assessing absolute CVD risk.
• Australian guidelines define absolute CVD risk as the probability of major cardiovascular events within 5 years.

Purpose of the Study:

• To outline the current Australian guidelines for assessing and managing absolute cardiovascular disease (CVD) risk.
• To provide guidance on treatment strategies based on calculated absolute CVD risk levels.

Main Methods:

• Utilizing the Australian absolute CVD risk calculator for patients aged 45+ (or 35+ for Aboriginal and Torres Strait Islander people).
• Calculating risk using pre-treatment values for patients on blood pressure (BP)-lowering or lipid-lowering agents.
• Employing oscillometric BP measurements to approximate mean daytime ambulatory BP.

Main Results:

• High absolute CVD risk patients (>15% over 5 years) should receive both BP-lowering and lipid-lowering agents.
• Moderate risk patients (10%-15%) may require medication if risk persists post-lifestyle changes, or if BP is ≥ 160/100 mmHg, or based on ethnicity and family history.
• Specific ethnic groups and individuals with a family history of premature CVD are considered for treatment at moderate risk levels.

Conclusions:

• Regular assessment of absolute CVD risk is crucial for effective primary prevention of cardiovascular events.
• Tailored treatment strategies, combining lifestyle modifications and pharmacotherapy, are essential for managing cardiovascular risk in diverse patient populations.
• The guidelines emphasize a proactive approach to CVD prevention by identifying and treating individuals at elevated risk.