2023 Guideline for assessing and managing CVD risk and Australian CVD risk calculator

The guideline provides recommendations and practice advice for assessing, communicating, and managing CVD risk for the primary prevention of CVD in Australia.

The guideline includes:

• recommendations for when and how to assess CVD risk

• guidance and tools for using the new Aus CVD Risk Calculator

• practical advice on how to apply the recommendations

• tools to support communicating CVD risk

• recommendations on how to manage CVD risk

• a summary of the available evidence supporting the recommended approaches to risk assessment and management, together with the rationale for how available evidence has been interpreted for the Australian setting

• specific recommendations, resources and practice points for assessing and managing CVD risk in First Nations people.

This guideline is intended for use by general practitioners, First Nations health workers and practitioners, nurses and nurse practitioners, allied health professionals, other primary care health professionals and physicians who support the primary prevention of CVD.

• A new risk equation modified and recalibrated specifically for the Australian population to give a more accurate assessment of CVD risk. It is also the first Australian CVD risk calculator to account for socioeconomic disadvantage and diabetes specific risk factors.

• A broader range of people without known CVD aged 45–79 years now recommended to have their risk assessed using the Aus CVD Risk Calculator.

• New risk categories defined according to the new Aus CVD Risk Calculator:

  • High (≥10% risk over 5 years

  • Intermediate (5 to <10% risk over 5 years)

  • Low (<5% risk over 5 years)

• New guidance provided on factors that may help clinicians refine and reclassify risk estimates when using the Aus CVD Risk Calculator; this is particularly relevant for people whose calculated risk is close to the threshold of another risk category.

• New emphasis on communicating risk effectively to support shared decision-making between primary care clinicians and patients.

• Specific recommendations, resources and practice advice for First Nations people embedded throughout the guideline.

The new Australian cardiovascular disease risk calculator (Aus CVD Risk Calculator) is based on the NZ PREDICT-1° equation, which was developed from a large, contemporary New Zealand primary care cohort study. The equation has been recalibrated to the Australian population and modified for the Australian healthcare system for more accurate CVD risk assessment.  It is the first Australian CVD risk calculator to account for socioeconomic disadvantage and diabetes specific risk factors.

The new guideline has been developed according to the processes and standards outlined in the 2016 National Health and Medical Research Council’s (NHMRC) Guidelines for Guidelines.

The guideline was developed under the direction and governance of a Guideline Advisory Group consisting of senior executives of ACDPA member organisations, an Expert Steering Group and seven advisory groups with multi-disciplinary, clinical and consumer input. Special attention was given to First Nations people’s health, and the Indigenous Health Expert Subgroup advised on every aspect of the guideline development.

Read more about how the guideline was developed here.

Endorsement

This guideline is endorsed by the Royal Australian College of General Practitioners (RACGP).