Do you need a cardiovascular risk calculator in Australia?
Here are some facts about cardiovascular disease:
Cardiovascular disease (CVD) is the leading cause of death in Australia. It affects more than 4 million Australians, causing 26% of all deaths (Source: Heart Foundation). It’s important to know if you are at risk. The earlier you know, the earlier you can make lifestyle changes to lower your risk; such as eating healthy, exercising and maintaining a healthy weight.
That’s why the National Vascular Disease Prevention Alliance (NVDPA) created guidelines and a risk calculator to help people find out their risk of cardiovascular disease. With the information you get from this calculator, your doctor can help you prevent CVD.
The National Vascular Disease Prevention Alliance (NVDPA) is a group of health related organisations including the:
- National Stroke Foundation
- Diabetes Australia
- Kidney Health Australia
- National Heart Foundation of Australia
The goal of this group is to reduce cardiovascular disease in Australia.
What is cardiovascular disease?
Cardiovascular disease is a term for a range of diseases that affect the heart as well as the large network of blood vessels in the body. These conditions include:
- Heart disease and atherosclerosis
- Stroke
- Peripheral vascular disease
- Childhood heart disease
If you are looking for statistics about heart, stroke and vascular diseases in Australia, you can find them here:
What is a cardiovascular risk calculator?
A cardiovascular risk calculator is a tool used to find out if you are at a high risk of cardiovascular disease over the next five years (Source: Heart Foundation).
It figures out your risk by examining multiple factors that help predict a heart attack or a stroke event in a five year time period.
A cardiovascular risk calculation is part of what is called a heart health check. This is a Medicare supported 20 minute check you can take with your doctor that includes:
- Gathering information about your potential risk for CVD
- Figuring out your absolute CVD risk using a validated calculator
- If you have a risk for CVD, helping you manage that risk on an ongoing basis
The cardiovascular risk calculator was created using the Australian Guidelines for the management of absolute cardiovascular disease risk – a series of guidelines created by the NVDPA to inform the diagnosis of cardiovascular diseases.
How does the cardiovascular risk calculator work?
The cardiovascular risk calculator works by collecting your specific details, including;
- Gender
- Age (35-74 years)
- Systolic Blood Pressure (75 or more mmHg)
- Smoking Status (i.e. whether you are currently smoking or have quit in the past year)
- Total Cholesterol (mmol/L)
- High Density Lipoprotein (HDL) Cholesterol (mmol/L)
- Whether or not you have diabetes
- ECG in Left Ventricular Hypertrophy (whether you have it, don’t have it or are unsure)
Once these details are taken, the calculator compiles a score that finds out your likelihood for cardiovascular disease over the course of the next five years. This score is either:
- < 10% for low risk
- 10-15% for moderate risk
- > 15% for high risk
(Source: CVD Check)
What are the CVD Risk guidelines?
The CVD risk guidelines are a document written by the NVDPA that outline:
- How best to figure out your CVD risk
- What CVD risks mean for you
- What courses of treatment to help you manage CVD risks
As mentioned previously, there are three levels of CVD risk; low risk, moderate risk and high risk.
Low Risk
You are at low risk if your CVD risk is lower than 10%. (Source: CVD Absolute Risk Guidelines via Heart Foundation)
If your risk of CVD is low, your treatment won’t be as extensive. Your doctor probably won’t prescribe you medication. Instead, your doctor will be more likely to provide health and lifestyle advice that helps you maintain healthier habits.
Your absolute risk will also be reviewed less frequently than those with moderate to high risk.
Moderate Risk
You are at moderate risk if your CVD risk is between 10 and 15%. (Source: CVD Check)
Because the moderate risk of CVD is somewhat manageable, it is up to you and your doctor to figure out what your treatment needs to be.
Your doctor will offer you lifestyle advice, as well as potentially prescribe medication (but only if absolutely necessary).
Because the risk is lower, your CVD risk needs less frequent reviewing than if your risk was high.
High Risk
You are at high risk if your CVD risk is higher than 15%. (Source: CVD Check)
Due to the higher risk of CVD, the treatments designated in the guides are more hands on. Your doctor will help support you to adopt lifestyle choices such as eating healthy, stopping smoking and avoiding alcohol.
The doctor might also prescribe you medication in order to lower lipids as well as your blood pressure.
Because of the high risk present, it is important that your CVD risk is reviewed regularly.
What kinds of treatments are recommended, depending on risk?
There are multiple treatments that your doctor can use in order to address your potential CVD risk, as outlined in the CVD guidelines.
These guidelines focus on four factors for treatment:
Lifestyle
The healthier your lifestyle (i.e. diet, exercise, etc.), the lower your likelihood of developing CVD.
- If you are high risk, your doctor will:
- Offer you frequent and sustained specific advice and support for diet and exercise
- Give advice and support to help you stop smoking
- Offer advice and may prescribe medication to reduce your blood pressure and lipids
- If you are moderate risk, your doctor will:
- Give you specific, but less frequent advice and support regarding diet and exercise
- Give advice and support to help you stop smoking
- Give you lifestyle advice, while only prescribing medication if absolutely necessary
- If you are low risk, your doctor will:
- Give you brief, general advice and support regarding diet and exercise
- Give advice and support to help you stop smoking
Medication
Sometimes, you need medical intervention in order to lower your CVD risk.
- If you are high risk, your doctor may prescribe medications that lower both your lipids and blood pressure
- If you are moderate risk, it is unlikely that your doctor will prescribe medication, only doing so under any of the following circumstances;
- If 3-6 months of a healthy lifestyle fails to lower your CVD risk
- If your blood pressure is persistently higher than or equal to 160/100 mmHg
- If you have a family history of premature CVD
- If you are part of a specific population where a CVD calculator underestimates your risk (i.e. Aboriginal and Torres Strait Islanders, South Asian, Maori and Pacific Islanders, Middle Eastern, etc.)
- If you are low risk, your doctor will only prescribe medication in the event that your blood pressure is persistently higher than or equal to 160/100 mmHg
Targets
Targets give you specific goals to strive towards in order to improve your lifestyle. These targets don’t change based on your CVD risk.
Instead, these targets may include:
- Blood pressure levels
- Lifestyle habits such as:
- Stopping smoking
- Diet rich in fruit and vegetables (also low in salt, saturated fats and trans fats)
- At least 30 mins moderate intensity exercise daily
- Limited alcohol intake
Monitoring
Monitoring describes how often the doctor needs to check your CVD risk to make sure that the treatments measured above are working and your targets are being met.
- If you are high risk, the doctor will rely on clinical context to determine when to examine you for your CVD risk
- If you are moderate risk, your absolute CVD risk will be reviewed every 6-12 months
- If you are at a low risk, your absolute CVD risk will be reviewed every 2 years
How can the Life! program help me reduce my risk of cardiovascular disease?
In addition to using the cardiovascular risk calculator, you can use the Life! program’s health check, a short test that helps calculate your risk for cardiovascular disease. The Life! program also helps you improve your lifestyle so that you can reduce your risk of cardiovascular disease.
Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. You can choose from a group course or the telephone health coaching service.
Our experienced health professionals will help you make small changes to your lifestyle so that you can achieve your health goals and reduce your risk of type 2 diabetes and cardiovascular disease.
The Life! program is funded by the Victorian government and managed by Diabetes Victoria. You can check your eligibility for the program here.
Sources
https://www.heartfoundation.org.au/bundles/for-professionals/key-stats-cardiovascular-disease
https://www.heartfoundation.org.au/bundles/for-professionals/cvd-risk-calculator
https://www.heartfoundation.org.au/bundles/for-professionals/fp-absolute-risk-heart-health-checks
https://www.cvdcheck.org.au/calculator
Reviewers:
Elleni Kaias, Accredited Practicing Dietitian | Primary Care Engagement Lead
Kristie Cocotis, Head of Prevention and Health Promotion
Sarah Dubé, Strategy and Engagement Lead
Ria Cheripuram, Digital Communications Officer
Tegan Kohlman, Communications and Social Marketing Officer