The management of cardiovascular risk in the CVD consensus statement is based on revised thresholds for when to consider pharmacological treatment. These thresholds, in turn are based on calculations with the new risk equations which are not yet available in clinical practice.
Clinicians can classify patients as low, intermediate or high risk using existing Framingham-based equations, and follow the appropriate management recommendations for the same risk category in the CVD consensus statement Table 3. For further information on assessing high cardiovascular risk, see: Assessing cardiovascular risk in people with high clinical risk factors bpac NZ , Sep Table 3: The pharmacological management of cardiovascular risk based on the CVD consensus statement.
Cardiovascular medicines are not generally recommended as this is believed to be the point below at which the harms of treatment are likely to exceed the benefits of treatment. Cardiovascular risk changes with time. Repeat assessments should be conducted to ensure the approach to managing cardiovascular risk agreed to by patients and clinicians remains the most appropriate.
Annual reviews are recommended for people at high risk or people at intermediate risk managed with pharmacological treatments. Calculating cardiovascular risk is central to any CVD prevention strategy, the CVD risk assessment, however, requires clinical judgement and knowledge of the individual patient to determine if the calculated result is likely to under- or over-estimate risk.
For example, patients who are morbidly obese or have other exacerbating factors, such as an unhealthy lifestyle or using antipsychotic medicines for a serious mental illness, are likely to have a higher risk than that calculated.
A key concept to convey to patients is that cardiovascular risk is a continuum; meaning everyone has some risk, but some have more than others.
Patients need to be presented with information in a way that allows them to understand their cardiovascular risk and the potential effects of lifestyle or pharmacological interventions, in order to actively participate in shared decision-making. Allow sufficient opportunities for the patient to ask questions and ensure that they have understood the information in the way it was meant to be conveyed. Consider various ways in which risk and interventions can be explained or depicted, e.
For further information on communicating cardiovascular risk, see: Communicating cardiovascular risk effectively bpac NZ , Sep Discussions about cardiovascular health need to take into account that patients with similar estimations of cardiovascular risk may use the same information to make different decisions. Consider the following points when making recommendations to patients:. Further information The Heart Foundation has developed a resource page for health professionals for cardiovascular disease risk assessment and management, see: here.
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You can opt out of or into if currently out all comment notification emails by clicking the button below. Made with by the bpac nz team. Prescribing Reports. CME Quizzes. Peer Group Discussions. My Bpac account. Search Mybpac - Login. Clinical decision making informed by science. About Prior to surgery, patients and clinicians decide whether to proceed, partly determined by the balance of risk and benefits. Calculate Disclaimer nzRISK provides an estimate of the risk of death at one month, one and two years.
User notes. Age in years, 18 or above. Gender Male. ASA 1. Acuity Tick if acute. Cancer Tick if cancer present. If you are at low risk, it does not mean you have no risk - just a lesser risk.
Medication is not usually prescribed. However, you may be able to reduce whatever risk you do have even further by any relevant changes in lifestyle as described in the above paragraph. Some people with a low risk buy a low-dose statin drug from a pharmacy to lower their cholesterol level. Statin medicines are available on prescription and funded by the NHS if your risk is moderate or high. However, you need to buy them if your risk is in the low category.
If you do buy a statin and take it regularly, it is best to let your doctor know so that it can be put on your medical record. Take our quick 5 minute survey to share your thoughts on Patient.
Cardiovascular disease: risk assessment and reduction, including lipid modification ; NICE Guidance July - last updated N Engl J Med. Epub Feb So iv been having some strange things going on in my body the last month or so and I'm wondering if anyone can give me some incite on what might be going on.
The last two weeks have been the worst as Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
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