- Assessment based on new 5-year CVD risk prediction equations (NZ PREDICT study) using PMS tools (printed tables no longer appropriate).
- Start assessment earlier for high-risk people (Māori, Pacific and South-Asian: men from 30 years, women from 40 years; individuals with severe mental illness from 25 years).
- New high-risk groups (Heart failure, eGFR less than 30 ml/min and where available, diagnosis of asymptomatic carotid disease or coronary disease).
- Estimated 5-year risk of 15% or more is considered high-risk. Target BP 130/80 and LDL-C 1.8 mmol/l is recommended. Pharmacotherapy should be considered.
- Estimated 5-year risk of 5-15% – target BP of 130/80 and LDL-C reduction of 40% or greater is recommended. Consider pharmacological treatment with the benefits and harms of drugs presented and discussed to allow individualised informed decision about whether to start treatment.
- Consider aspirin under 70 years with 5-year risk of >15%. Benefits likely to outweigh risks.
This Gem has been checked by Associate Professor Gerry Devlin, Cardiologist and Medical Director and Dr Fraser Hamilton, GP Champion for the Heart Foundation.