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Cardiovascular disease risk assessment in the Australian primary care setting (EPOSTER: 6mins)

Presentation Description

Background: In a primary prevention setting, Australian guidelines recommend that all adults aged 45 years and over have their 5-year cardiovascular disease (CVD) risk assessed. While recommending calculated risk assessment, the guidelines also identify clinical characteristics that indicate an individual may be deemed clinically determined high risk without further assessment. This research aims to investigate the proportion of Australians with the appropriate CVD risk factors recorded to enable absolute CVD risk assessment and the proportion that are at clinically determined high risk.

Method: MedicineInsight is a large-scale national GP data program extracting and collating longitudinal, de-identified patient health records from clinical information systems. The population was restricted to individuals; without prior CVD, aged 45-74 years, with a minimum of 3 visits in the prior 12 months (n=172,366).

Results: Of this population; 65% had a TC:HDL ratio recorded, 85% had a systolic blood pressure (SBP) measurement, and 59% had both, within an appropriate time frame. When individuals were assessed against clinically determined high risk criteria; 6% of patients had a TC greater than 7.5 mmol/L, 5.4% had a SBP above 180 mmHg and 0.3% had an eGFR of 45 mL/min or less. Diabetics with microalbuminuria, or aged 60 years and older, made up 4 and 7.3% of the population respectively. Overall, 18.5% of individuals would be classified as clinically determined high risk based on recorded data.

Discussion: A substantial proportion of eligible individuals do not have sufficient CVD risk factor data recorded to enable formal risk screening. A significant number of patients may not require a full absolute CVD risk assessment and should be automatically classified and managed as high risk.

Implications for practice:
Overall, a significant number of Australians may be at clinically determined high risk and should be automatically managed with appropriate therapy.