New NZ CVD primary care guidelines

Goodfellow Gems Logo

Goodfellow Gems

New NZ CVD primary care Consensus Statement1,2

  1. Assessment based on new 5-year CVD risk prediction equations (NZ PREDICT study) using PMS tools (printed tables no longer appropriate).
  2. 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).
  3. New high-risk groups (Heart failure, eGFR less than 30 ml/min and where available, diagnosis of asymptomatic carotid disease or coronary disease).
  4. 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.
  5. 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.
  6. 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.

References:

  1. Cardiovascular Disease Risk Assessment and Management for Primary Care. NZ Ministry of Health (2018). Click here
  2. Heart Foundation NZ. Feb 2018 update. Click here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.



As published in NZ Doctor 28/03/2018