Combining Population and High-risk Strategies Could Prevent Heart Disease

Combining high-risk and population strategies is important for the prevention of cardiovascular disease (CVD) in Australia.

Combining high-risk and population strategies is important for the prevention of cardiovascular disease (CVD) in Australia, according to research published in the latest Medical Journal of Australia.

Prof Erkki Vartiainen, from the National Institute for Health and Welfare in Helsinki, Finland and Flinders University, and co-authors analysed data from 1116 people aged 35-74 years living in rural southeastern Australia who completed a CVD risk-factor survey from 2004-2006.

After applying the Framingham risk equations* to the data to calculate five-year probabilities of a coronary heart disease (CHD) event, stroke and cardiovascular event, the researchers modelled the effect of different changes in risk factors to assess the extent to which CVDs could be prevented by changing the risk factors at a population level (population strategy), among high-risk individuals (high-risk strategy), or both.

Prof Vartiainen said the study found that, in men, a population strategy could reduce cardiovascular events by 19.3 per cent, the high-risk strategy by 12.6 per cent, and a combined strategy by 24.1 per cent, and, in women, by 21.9 per cent, 19 per cent, and 28.7 per cent respectively.

“The results of the analyses support the need for combining high-risk and population strategies,” Prof Vartiainen said.

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“For effective strategies to reduce cardiovascular risk, the population-level data on risk factors and their predictive value for morbidity and mortality are needed … to estimate the possible effects of different interventions.

“Data are also needed to estimate the proportion of the population at high risk and the resources required to intervene.

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“These estimates are crucial for planning national preventive and management programs.”

Prof Vartiainen said that, in many countries, reductions in risk-factor levels had been followed by a major reduction in CHD mortality.

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“In most Western countries, there has been a major reduction in CVD risk factors, resulting in considerable decline in mortality,” he said.

“These analyses indicate that still more can be done to reduce the CVD burden.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source-MJA