Updated calculator changes who is flagged for discussion
Australia’s revised cardiovascular disease risk calculator is identifying a substantially larger share of adults as being at intermediate risk of a heart attack or stroke, according to an analysis published in the Medical Journal of Australia. The shift could change the number of people who are prompted to discuss preventive treatment with a general practitioner.
Researchers from the Australian National University and QIMR Berghofer examined data from more than 115,000 people aged 45 to 74 who had visited a GP between 2020 and 2022. None had a recorded history of heart disease or stroke. The researchers compared results from Australia’s updated 2023 risk calculator with those from the previous version published in 2012.
The newer calculator was introduced to align risk assessment with revised national guidelines. Its effect in the study was not simply to move people into or out of concern altogether. It substantially redistributed risk classifications, especially by increasing the intermediate-risk group.
More people fall into the intermediate category
Using the 2023 calculator, 9.7% of the study population was classified as being at high risk of a cardiovascular event within five years. In this group, preventive medication would routinely be recommended under the framework described in the report.
Another 26.4% of participants were classified as intermediate risk. For this group, treatment should be considered in light of individual circumstances. The remaining 63.9% were classified as low risk.
The contrast with the 2012 calculator is sharp. Under the older approach, 17.6% of people were classified as high risk, while 11.6% were classified as intermediate risk. The newer approach therefore more than doubled the proportion placed in the intermediate category, while reducing the share labelled high risk.
That distinction is important because an intermediate classification is not an automatic prescription. It is a prompt for a clinical conversation: a patient and clinician can consider risk alongside personal circumstances and possible preventive options. The updated tool may therefore widen the group for whom prevention becomes an active topic in primary care.
Risk assessment is one part of prevention
Cardiovascular disease remains one of Australia’s leading causes of death. The report notes that blood-pressure-lowering and cholesterol-lowering medicines, as well as stopping smoking and improving diet, can substantially reduce the chance of a heart attack or stroke.
Risk calculators are designed to organize information about a person’s likelihood of a cardiovascular event over a defined period. They do not replace medical advice, diagnosis or a discussion of the benefits and drawbacks of treatment. The study’s findings instead show how the choice of calculator can affect the size and makeup of the population identified for those discussions.
For people classified at high risk, the study describes preventive medication as routinely recommended. For those at intermediate risk, the decision is more individualized. That makes the large expansion of this category consequential: it creates more opportunities for clinicians and patients to evaluate prevention before a cardiovascular event occurs.
A population-level result with individual implications
The analysis is based on a large group of Australians who had recently attended general practice, giving it direct relevance to how risk assessment can appear in everyday care. It does not mean that every adult aged 45 to 74 has the same risk, or that everyone in the intermediate category should receive the same treatment.
Rather, it suggests the revised national framework identifies many more people whose risk merits consideration. Dr. Ellie Paige, who leads QIMR Berghofer’s Cardiovascular Disease Prevention Team and is a visiting research fellow at ANU, described the change as an opportunity for earlier action.
The result also illustrates a broader policy trade-off in preventive medicine. A tool that reserves the highest-risk label for fewer people may still expand prevention by recognizing a larger middle group in which treatment can be discussed before risk becomes more acute. The value of that shift will depend on how consistently the calculator is used, how clinicians interpret it and whether patients can access appropriate support.
For Australians in the studied age range, the immediate takeaway is not to self-classify from a population statistic. It is that the updated calculator may change the conversation at a GP visit. A cardiovascular risk assessment can provide a basis to discuss blood pressure, cholesterol, smoking, diet and, where appropriate, medicines intended to reduce the chance of a future heart attack or stroke.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
