Patients at high risk of a heart attack or stroke are under treated

Australian research has confirmed substantial under treatment of patients who are at risk of cardiovascular disease. The new research shows that up to 70% of patients who are at a high risk of a heart attack or stroke in the next 5 years aren’t receiving the care required to prevent these conditions. Findings also show that 50% of older patients who have had a heart attack or stroke aren’t receiving the care or treatments they need to prevent a second attack.

Cardiovascular disease is the leading cause of death worldwide and in Australia it is responsible for around 35% of deaths. Evidence shows the best way to prevent cardiovascular disease is to assess a patient’s absolute risk of cardiovascular disease by conducting a comprehensive review of all possible major risk factors and treat those patients identified as high risk using evidence based therapies.

"We know that the major risk factors for cardiovascular disease act together, so it’s vital that patient risk factors such as age, diabetes, cholesterol and blood pressure are considered altogether to estimate their future risk of a heart attack or stroke and treated accordingly. Unfortunately our study showed that many patients who are at risk are missing out on this type of care. Practitioners are also underestimating a patient’s risk," says lead author Dr Emma Heeley, The George Institute.

"What we need to realise is that 90% of Australian adults have at least one modifiable risk factor - so there really is a lot we can do to reduce the impact of cardiovascular disease in Australia. Prevention efforts targeted to patients at high risk will also prove highly cost-effective", Dr Heeley added.

The results, which are published in today’s Medical Journal of Australia, suggest that a more considered effort is required to rationalise the guidelines for cardiovascular disease risk assessment and management, and make it simpler for clinicians.

"These findings provide a valuable learning for the Rudd government’s National Primary Health Care Strategy, which has prioritised the management cardiovascular disease as an urgent issue. This is an opportunity for Australian patients to receive better care, and for clinicians to be provided with better tools to treat patients", said Dr Heeley.

Researchers examined cardiovascular disease risk in Australian primary care, and looked at the proportion of patients who received appropriate treatment. Over 300 general practitioners (GPs) were surveyed, which provided a total of 5293 patients. The study was unconditionally funded by Servier laboratories (Australia).