Evaluation of the First 12 Months of a Cardiovascular Disease (CVD) Risk Assessment and Treatment Program at Tāmaki Healthcare Primary Health Organisation, Auckland, New Zealand

2008 ◽  
Vol 17 ◽  
pp. S156
Author(s):  
David Peiris ◽  
Jonathan Murray ◽  
Doreen Scully ◽  
Virantha Tilakawardane ◽  
Lorraine Hetaraka-Stevens ◽  
...  
2012 ◽  
Vol 4 (3) ◽  
pp. 181 ◽  
Author(s):  
Tom Robinson ◽  
C Raina Elley ◽  
Sue Wells ◽  
Elizabeth Robinson ◽  
Tim Kenealy ◽  
...  

INTRODUCTION: New Zealand (NZ) guidelines recommend treating people for cardiovascular disease (CVD) risk on the basis of five-year absolute risk using a NZ adaptation of the Framingham risk equation. A diabetes-specific Diabetes Cohort Study (DCS) CVD predictive risk model has been developed and validated using NZ Get Checked data. AIM: To revalidate the DCS model with an independent cohort of people routinely assessed using PREDICT, a web-based CVD risk assessment and management programme. METHODS: People with Type 2 diabetes without pre-existing CVD were identified amongst people who had a PREDICT risk assessment between 2002 and 2005. From this group we identified those with sufficient data to allow estimation of CVD risk with the DCS models. We compared the DCS models with the NZ Framingham risk equation in terms of discrimination, calibration, and reclassification implications. RESULTS: Of 3044 people in our study cohort, 1829 people had complete data and therefore had CVD risks calculated. Of this group, 12.8% (235) had a cardiovascular event during the five-year follow-up. The DCS models had better discrimination than the currently used equation, with C-statistics being 0.68 for the two DCS models and 0.65 for the NZ Framingham model. DISCUSSION: The DCS models were superior to the NZ Framingham equation at discriminating people with diabetes who will have a cardiovascular event. The adoption of a DCS model would lead to a small increase in the number of people with diabetes who are treated with medication, but potentially more CVD events would be avoided. KEYWORDS: Cardiovascular disease; diabetes; prevention; risk assessment; reliability and validity


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Digsu Koye ◽  
Karen Lamb ◽  
Ping-Wen Lee ◽  
Aneta Kotevski ◽  
Javier Haurat ◽  
...  

Abstract Background HealthGap is a population-based cohort study aiming to understand health inequities in cardiovascular disease (CVD) risk between Indigenous and non-Indigenous Australians. We examined guideline-based CVD risk assessment in Victoria. Methods NPS MedicineInsight, the largest Australian primary health care dataset, provided data on CVD risk factors (age, gender, smoking status, diabetes, systolic blood pressure (SBP), total and HDL cholesterol) and Aboriginal or Torres Strait Islander (Indigenous) status. The percentage of patients who had all risk factors measured was calculated and compared by Indigenous status. Results In total, 7,928 of 1,435,111 patients were classified as Indigenous. The percentage of patients with measured cholesterol was slightly lower for Indigenous (total cholesterol=31.4%, HDL=26.9%) than non-Indigenous patients (total cholesterol=35.6%, HDL=31.8%). However, more Indigenous patients had SBP measured (65.6% vs. 59.8%). Diabetes diagnosis was higher among Indigenous patients (6.2% vs. 3.6%). There was a small difference in the proportions with all risk factors measured between Indigenous and non-Indigenous patients (24.1% vs. 26.6%). Among Indigenous patients aged at least 35 years who should have had their risk assessment measured, 41.9% had all risk factors measured, while 50.7% of the non-Indigenous Australians (aged ≥45 years) had all risk factors measured. Conclusions Overall, the proportion of people with all CVD risk factors measured was smaller for Indigenous compared to non-Indigenous people. Key messages Fewer than half of Indigenous Australians have CVD risk factors captured in a primary health care setting. This has implications for health care policy and programs seeking to improve CV health outcomes among Indigenous Australians.


2019 ◽  
Vol 2 (1) ◽  
pp. 4-11
Author(s):  
Rungkarn Inthawong ◽  
Khaled Khatab ◽  
Malcolm Whitfield ◽  
Karen Collins ◽  
Maruf A. Raheem ◽  
...  

2021 ◽  
pp. BJGP.2020.1038
Author(s):  
Denise Ann Taylor ◽  
Katharine Wallis ◽  
Sione Feki ◽  
Sione Segili Moala ◽  
Manusiu He-Naua Esther Latu ◽  
...  

Background: Despite cardiovascular disease (CVD) risk prediction equations becoming more widely available for people aged 75 years and over, views of older people on CVD risk assessment are unknown. Aim: To explore older people’s views on CVD risk prediction and its assessment. Design and Setting: Qualitative study of community dwelling older New Zealanders. Methods: We purposively recruited a diverse group of older people. Semi-structured interviews and focus groups were conducted, transcribed verbatim and thematically analysed. Results: Thirty-nine participants (mean age 74 years) of Māori, Pacific, South Asian and European ethnicities participated in one of 26 interviews or three focus groups. Three key themes emerged, (1) Poor knowledge and understanding of cardiovascular disease and its risk assessment, (2) Acceptability and perceived benefit of knowing and receiving advice on managing personal cardiovascular risk; and (3) Distinguishing between CVD outcomes; stroke and heart attack are not the same. Most participants did not understand CVD terms but were familiar with ‘heart attack,’ ‘stroke’ and understood lifestyle risk factors for these events. Participants valued CVD outcomes differently, fearing stroke and disability which might adversely affect independence and quality of life, but being less concerned about a heart attack, perceived as causing less disability and swifter death. These findings and preferences were similar across ethnic groups. Conclusion: Older people want to know their CVD risk and how to manage it, but distinguish between CVD outcomes. To inform clinical decision making for older people, risk prediction tools should provide separate event types rather than just composite outcomes.


2009 ◽  
Vol 1 (3) ◽  
pp. 226
Author(s):  
Sarah Waldron ◽  
Margaret Horsburgh

BACKGROUND AND CONTEXT: Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice. METHOD : A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average). RESULTS: Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had a five year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period. STRATEGIES FOR IMPROVEMENT: The recently available ‘heart health’ trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends. LESSONS: Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health. KEYWORDS: Cardiovascular disease risk assessment; nurse clinics; audit


Author(s):  
Audrey A. Opoku-Acheampong ◽  
Richard R. Rosenkranz ◽  
Koushik Adhikari ◽  
Nancy Muturi ◽  
Cindy Logan ◽  
...  

Cardiovascular disease (CVD, i.e., disease of the heart and blood vessels) is a major cause of death globally. Current assessment tools use either clinical or non-clinical factors alone or in combination to assess CVD risk. The aim of this review was to critically appraise, compare, and summarize existing non-clinically based tools for assessing CVD risk factors in underserved young adult (18–34-year-old) populations. Two online electronic databases—PubMed and Scopus—were searched to identify existing risk assessment tools, using a combination of CVD-related keywords. The search was limited to articles available in English only and published between January 2008 and January 2019. Of the 10,383 studies initially identified, 67 were eligible. In total, 5 out of the 67 articles assessed CVD risk in underserved young adult populations. A total of 21 distinct CVD risk assessment tools were identified; six of these did not require clinical or laboratory data in their estimation (i.e., non-clinical). The main non-clinically based tools identified were the Heart Disease Fact Questionnaire, the Health Beliefs Related to CVD-Perception measure, the Healthy Eating Opinion Survey, the Perception of Risk of Heart Disease Scale, and the WHO STEPwise approach to chronic disease factor surveillance (i.e., the STEPS instrument).


2019 ◽  
Vol 54 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Laura M Thompson ◽  
Natalie L Tuck ◽  
Sarah D Pressman ◽  
Nathan S Consedine

Abstract Background Expressing emotions effectively is central to social functioning and has links to health and cardiovascular disease (CVD) risk. Previous work has linked the ability to smile to lower CVD risk in men but has not studied other expressions or considered the context of these skills. Purpose To test whether the ability to express fear, anger, sadness, happiness, and disgust cross-sectionally predict CVD risk in both genders and whether links are moderated by the ability to decode others’ emotional signals. Methods A community sample of 125 men and women (30–75 years) provided trait emotion data before a laboratory visit where blood was drawn and performance-based assessments of the ability to signal and decode emotions were administered. Expressive accuracy was scored using FaceReader software. Projected CVD risk was calculated using Framingham, a New Zealand (NZ) specific, and Atherosclerosis CVD (ASCVD) risk algorithms. Results Accuracy expressing happiness predicted lower projected risk, whereas greater accuracy expressing fear and sadness predicted higher risk. Gender frequently moderated these links; greater accuracy expressing happiness predicted lower risk in men but not women. Conversely, greater accuracy expressing fear predicted higher risk in men, whereas greater accuracy expressing sadness predicted lower risk in women but, again, higher risk in men. The ability to accurately decode others’ emotions moderated some links. Conclusions The ability to signal emotion has complex links to health parameters. The ability to flexibly regulate expressions in accordance with gender norms may be one useful way of thinking about adaptive expressive regulation.


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