{
  "abstract": "In the healthcare field, we treat disease. When high blood pressure was first recognised by insurance actuaries as an adverse mortality risk, we adopted the term ‘hypertension’ as a disease in fitting with that approach. Adverse lipid profiles were added to the disease list, too, with arbitrary but evidence-based diagnostic thresholds and treatment targets. When patients had manifest cardiovascular disease, such as a myocardial infarction or stroke, the need for therapy was unquestionable, but what of those without? Even though those with manifest disease are most at risk, if you wish to prevent the greatest numbers of events, you must intervene in the primary prevention sector due to the overwhelming population numbers. Initially, individual risk factors were treated as per secondary prevention. However, it has been recognised for decades that the absolute benefit of medicalising and treating an individual is driven by their absolute risk.1 It has been estimated in the Australian population that such an approach would reduce cardiovascular events in men by 12.6% and even more so in women.2 One of the benefits of risk estimation is that it avoids observer bias. Women are at lower relative risk compared with men and therefore are less likely to have risk factors treated. Where such adverse risk may be subsumed within other disease management, for example, women with diabetes, this perception drives adverse outcomes. A formal risk calculation addresses this, as well as avoiding medicalisation and overtreatment of low-risk individuals while continuing to address adverse lifestyle factors. To facilitate uptake of this approach in Australia, the National Vascular Disease Prevention Alliance developed a guideline and calculator first published in 2012 and updated in 2023.3 4",
  "authors": [
    {
      "affiliations": [
        "Discipline of General Practice, University of Tasmania Menzies Institute for Medical Research, Hobart, Tasmania, Australia"
      ],
      "name": "Mark R Nelson"
    }
  ],
  "title": "Cardiovascular disease risk assessment in Australian primary care",
  "uid": "b1a6ed50-4ec6-542e-8748-c00280f67fef"
}