TY - JOUR
T1 - Cardiovascular risk perception and evidence - practice gaps in Australian general practice (the AusHEART study)
AU - Heeley, Emma
AU - Peiris, David
AU - Patel, Anushka
AU - Cass, Alan
AU - Weekes, Andrew
AU - Morgan, Claire
AU - Anderson, Craig
AU - Chalmers, John
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Objective: To examine the perception and management of cardiovascular disease (CVD) risk in Australian primary care. Design, setting and participants: The Australian Hypertension and Absolute Risk Study (AusHEART) was a nationally representative, cluster-stratified, cross-sectional survey of 322 general practitioners. Each GP was asked to collect data on CVD risk factors and their management in 15-20 consecutive patients aged ≥55 years who presented between April and June 2008, and to estimate each patient's absolute risk of a cardiovascular event in the next 5 years. Main outcome measures: Estimated 5-year risk of a cardiovascular event, proportion of patients receiving appropriate treatment. Results: Among 5293 patients, 29% (1548) had established CVD. A further 22% (1145), when categorised according to the 2009 National Vascular Disease Prevention Alliance guideline, to 42% (2211), when categorised according to National Heart Foundation (NHF) 2004 guideline, had a high (≥15%) 5-year risk of a cardiovascular event. Of the 1548 patients with established CVD, 50% were prescribed a combination of a blood pressure (BP)-lowering medication, a statin and an antiplatelet agent, and 9% were prescribed a BP-lowering medication and a statin but not an antiplatelet agent. Among high-risk patients without established CVD, categorised using NHF 2004 adjustments, 34% were prescribed a combination of a BP-lowering medication and a statin. GPs estimated 60% of patients with established CVD as having a risk of less than 15%. The GPs' estimates of risk among patients without established CVD agreed with the centrally calculated estimate (according to the NHF 2004 guideline) in 48% of instances (κ= 0.21). Conclusions: These data confirm substantial undertreatment of patients who are at high risk of a cardiovascular event. We recommend that GPs assess absolute risk for older patients and ensure that high-risk patients receive evidence-based pharmacotherapy.
AB - Objective: To examine the perception and management of cardiovascular disease (CVD) risk in Australian primary care. Design, setting and participants: The Australian Hypertension and Absolute Risk Study (AusHEART) was a nationally representative, cluster-stratified, cross-sectional survey of 322 general practitioners. Each GP was asked to collect data on CVD risk factors and their management in 15-20 consecutive patients aged ≥55 years who presented between April and June 2008, and to estimate each patient's absolute risk of a cardiovascular event in the next 5 years. Main outcome measures: Estimated 5-year risk of a cardiovascular event, proportion of patients receiving appropriate treatment. Results: Among 5293 patients, 29% (1548) had established CVD. A further 22% (1145), when categorised according to the 2009 National Vascular Disease Prevention Alliance guideline, to 42% (2211), when categorised according to National Heart Foundation (NHF) 2004 guideline, had a high (≥15%) 5-year risk of a cardiovascular event. Of the 1548 patients with established CVD, 50% were prescribed a combination of a blood pressure (BP)-lowering medication, a statin and an antiplatelet agent, and 9% were prescribed a BP-lowering medication and a statin but not an antiplatelet agent. Among high-risk patients without established CVD, categorised using NHF 2004 adjustments, 34% were prescribed a combination of a BP-lowering medication and a statin. GPs estimated 60% of patients with established CVD as having a risk of less than 15%. The GPs' estimates of risk among patients without established CVD agreed with the centrally calculated estimate (according to the NHF 2004 guideline) in 48% of instances (κ= 0.21). Conclusions: These data confirm substantial undertreatment of patients who are at high risk of a cardiovascular event. We recommend that GPs assess absolute risk for older patients and ensure that high-risk patients receive evidence-based pharmacotherapy.
UR - https://www.mja.com.au/journal/2010/192/5/cardiovascular-risk-perception-and-evidence-practice-gaps-australian-general
UR - http://www.scopus.com/inward/record.url?scp=77950613793&partnerID=8YFLogxK
U2 - 10.5694/j.1326-5377.2010.tb03502.x
DO - 10.5694/j.1326-5377.2010.tb03502.x
M3 - Article
VL - 192
SP - 254
EP - 259
JO - Medical Journal of Australia
JF - Medical Journal of Australia
SN - 0025-729X
IS - 5
ER -