Australian guideline and calculator for assessing and managing cardiovascular disease risk

Overview of process for cardiovascular disease (CVD) risk assessment and management

Identify people for
CVD risk assessment

Age ranges for assessing CVD risk in people without known CVD

  • All people aged 45–79 years
  • People with diabetes aged 35-79 years
  • First Nations people aged 30–79 years. Assess individual CVD risk factors in First Nations people aged 18–29 years.

Identify CVD risk category

Estimated 5–year CVD risk

High: ≥10%

Intermediate: 5% to <10%

Low: <5%

Reclassification factors

These factors may move an individual's risk estimate up or down:

  • Ethnicity
  • CAC
  • Family history
  • eGFR & uACR
  • Severe mental illness

Manage CVD risk

Lifestyle* factors

  • Smoking
  • Nutrition
  • Physical activity
  • Healthy weight
  • Alcohol

Pharmacotherapy

  • BP-lowering treatment
  • Lipid-modifying treatment

Use calculator to assess
CVD risk

Use new Australian CVD risk calculator with the following variables:

  • Age, sex
  • Smoking status
  • Systolic BP
  • TC: HDL-C ratio
  • Diabetes status
  • CVD medicines
  • Postcode
  • History of AF

For people with diabetes:

  • HbA1c
  • Time since diagnosis of diabetes
  • uACR
  • eGFR
  • BMI
  • Insulin

Do not use calculator in those already known to be at high risk: Moderate-to-severe CKD and FH

Communicate CVD risk

  • Communicate CVD risk using a variety of formats
  • Use a decision aid to support effective risk communication
  • Combine risk communication tools with behavioural strategies, repeated over time
  • Identify people for
    CVD risk assessment

  • Use calculator to
    assess CVD risk

  • Identify CVD risk
    category

  • Communicate
    CVD risk

  • Manage
    CVD risk

Identify people for
CVD risk assessment

Age ranges for assessing CVD risk in people without known CVD

  • All people aged 45–79 years
  • People with diabetes aged 35-79 years
  • First Nations people aged 30–79 years. Assess individual CVD risk factors in First Nations people aged 18–29 years.

Use calculator to assess
CVD risk

Use new Australian CVD risk calculator with the following variables:

  • Age, sex
  • Smoking status
  • Systolic BP
  • TC: HDL-C ratio
  • Diabetes status
  • CVD medicines
  • Postcode
  • History of AF

For people with diabetes:

  • HbA1c
  • Time since diagnosis of diabetes
  • uACR
  • eGFR
  • BMI
  • Insulin

Do not use calculator in those already known to be at high risk: Moderate-to-severe CKD and FH

Identify CVD risk category

Estimated 5–year CVD risk

High: ≥10%

Intermediate: 5% to <10%

Low: <5%

Reclassification factors

These factors may move an individual's risk estimate up or down:

  • Ethnicity
  • CAC
  • Family history
  • eGFR & uACR
  • Severe mental illness

Communicate CVD risk

  • Communicate CVD risk using a variety of formats
  • Use a decision aid to support effective risk communication
  • Combine risk communication tools with behavioural strategies, repeated over time

Manage CVD risk

Lifestyle* factors

  • Smoking
  • Nutrition
  • Physical activity
  • Healthy weight
  • Alcohol

Pharmacotherapy

  • BP-lowering treatment
  • Lipid-modifying treatment
  • AF: atrial fibrillation; BMI: body mass index; BP: blood pressure; CAC: coronary artery calcium; CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; FH: familial hypercholesterolaemia; HbA1c: haemoglobin A1c; HDL-C: high-density lipoprotein cholesterol; TC: total cholesterol; uACR: urine albumin-to-creatinine ratio. Family history: coronary heart disease (CHD) or stroke in a first-degree female relative aged <65 years or a first-degree male relative aged <55 years. Severe mental illness: a current or recent mental health condition requiring specialist treatment, whether received or not, in the 5 years prior to the CVD risk assessment. Derived from PREDICT cohort.50
  • * This guideline refers to certain modifiable risk factors as ‘lifestyle’ factors. However, it is recognised that these behaviours are not necessarily an individual’s choice, but reflect the complex interplay of social, cultural, and environmental factors, which may be further influenced by clinical conditions. Use of the term ‘lifestyle’ does not attribute blame to a person.