Online CVD Guidelines – Risk Assessment Algorithm

Proceed to Risk Calculator

Target Group for Assessment

  • All adults aged 45 years and over without known history of CVD (EBR Grade B)
  • Aboriginal and Torres Strait Islander peoples aged 30 years or older (EBR Grade D)

Consider the following as part of a comprehensive risk assessment: (PP)

Modifiable Risk Factors

  • Smoking status*
  • Blood pressure*
  • Serum lipids*
  • Waist circumference and BMI
  • Nutrition
  • Physical activity level
  • Alcohol intake*

Non-Modifiable Risk Factors

  • Age* and sex*
  • Family history or premature CvD
  • Social history including cultural identity, ethnicity, socioeconomic status and mental health

Related Conditions

  • Diabetes
  • Chronic Kidney Disease (albuminuria = urine protein, eGFR)
  • Familial hypercholesterolaemia*
  • Evidence of atrial fibrillation (history, examination, electrocardiogram)

Already known to be at risk?

Adults with any of the following conditions do not require absolute CVD risk assessment using the Framingham Risk Equation (FRE) because they are already known to be at clinically determined high risk of CVD: (EBR Grade D).

  • Diabetes and age > 60 years
  • Diabetes with microalbuminuria (> 20 mcg/min or urinary albumin:creatinine ratio > 2.5 mg/mmol for males, > 3.5 mg/mmol for females)
  • Moderate or severe CKD (persistent proteinuria or estimated giomerular filtration rate [eGFR] < 45 mL/min/1.73 m )
  • A previous diagnosis of familial hypercholesterolaemia
  • Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg
  • Serum total cholesterol > 7.5 mmol/L
  • Aboriginal and Torres Strait Islander adults aged over 74 (CBR)
Proceed to high risk guidelines

Yes

No

Calculate risk level using FRE (EBR Grade B)

  • Australian cardiovascular risk charts
  • Web calculator www.cvdcheck.org.au
  • Enter age 74 for adults aged 74+ (CBR)

High Risk

Greater than 15% risk of CVD within the next five years (includes clinically determined high risk) (PP)

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Moderate Risk

10-15% risk of CVD within the next five years (PP)

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Low Risk

Less than 10% risk of CVD within the next five years (PP)

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* Risk parameters that are included in the absolute risk calculator, based on the Framingham Risk Equation (FRE)
+ Alcohol is a risk factor for elevated blood pressure, stroke and cardiomyopathy (see NHMRC Guidelines to reduce health risks from drinking alcohol [2009]).
# Refer to National Heart Foundation of Australia's information sheet Familial Hypercholesterolaemia: Information for doctors.
BMI: body mass index. eGFR: estimated giomerular filtration rate. EBR: Evidence-based recommendation (Graded A-D). CBR: Consensus-based recommendation. PP: Practice point.