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.
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.
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.
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.
of the analyses support the need for combining high-risk and population
strategies," Prof Vartiainen said.
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.
estimates are crucial for planning national preventive and management programs."
Vartiainen said that, in many countries, reductions in risk-factor levels had been
followed by a major reduction in CHD mortality.
Western countries, there has been a major reduction in CVD risk factors,
resulting in considerable decline in mortality," he said.
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.