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Summary: This article reviews the risk equations recommended for use in international cardiovascular disease (CVD) primary prevention guidelines and assesses their suitability for use in Australia against a set of a priori defined selection criteria.The review and assessment were commissioned by the National Heart Foundation of Australia on behalf of the Australian Chronic Disease Prevention Alliance to inform recommendations on CVD risk estimation as part of the 2023 update of the Australian CVD risk assessment and management guidelines.Selected international risk equations were assessed against eight selection criteria: development using contemporary data; inclusion of established cardiovascular risk factors; inclusion of ethnicity and deprivation measures; prediction of a broad selection of fatal and non‐fatal CVD outcomes; population representativeness; model performance; external validation in an Australian dataset; and the ability to be recalibrated or modified.Of the ten risk prediction equations reviewed, the New Zealand PREDICT equation met seven of the eight selection criteria, and met additional usability criteria aimed at assessing the ability to apply the risk equation in practice in Australia. [ABSTRACT FROM AUTHOR]

Due to the imperfect nature of risk assessment and the long subclinical disease period, RCTs assessing the clinical impact of CVD risk assessment would need to be large-scale and long term to detect changes in CVD outcomes. Keywords: Risk management; Absolute risk; Surveillance EN Risk management Absolute risk Surveillance 103 105 3 02/21/23 20230215 NES 230215 Data on the expected effectiveness of a formal cardiovascular risk screening program are needed Population-based screening programs for early disease detection are important for preventing morbidity, disability, and premature death. A formal CVD risk screening program is likely to reduce the burden of CVD across the population, but we currently lack data to support this. Rather than diagnosing CVD, absolute CVD risk assessment quantifies the likelihood that an individual will experience a primary CVD event in given period of time. [Extracted from the article]

Summary: Cardiovascular disease (CVD) is a leading cause of preventable morbidity and mortality in Aboriginal and Torres Strait Islander peoples. This statement from the Australian Chronic Disease Prevention Alliance, the Royal Australian College of General Practitioners, the National Aboriginal Community Controlled Health Organisation and the Editorial Committee for Remote Primary Health Care Manuals communicates the latest consensus advice of guideline developers, aligning recommendations on the age to commence Aboriginal and Torres Strait Islander CVD risk assessment across three guidelines. Main recommendations: In Aboriginal and Torres Strait Islander peoples without existing CVD: CVD risk factor screening should commence from the age of 18 years at the latest, including for blood glucose level or glycated haemoglobin, estimated glomerular filtration rate, serum lipids, urine albumin to creatinine ratio, and other risk factors such as blood pressure, history of familial hypercholesterolaemia, and smoking status.Individuals aged 18–29 years with the following clinical conditions are automatically conferred high CVD risk: ▶type 2 diabetes and microalbuminuria;▶moderate to severe chronic kidney disease;▶systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg;▶familial hypercholesterolaemia; or▶serum total cholesterol > 7.5 mmol/L.Assessment using the National Vascular Disease Prevention Alliance absolute CVD risk algorithm should commence from the age of 30 years at the latest — consider upward adjustment of calculated CVD risk score, accounting for local guideline use, risk factor and CVD epidemiology, and clinical discretion.Assessment should occur as part of an annual health check or opportunistically. Subsequent review should be conducted according to level of risk. Changes in management as a result of this statement: From age 18 years (at the latest), Aboriginal and Torres Strait Islander adults should undergo CVD risk factor screening, and from age 30 years (at the latest), they should undergo absolute CVD risk assessment using the NVDPA risk algorithm. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that people who develop serious health conditions are likely to cease drinking alcohol (sometimes known as "sick‐quitters"). We quantified the likelihood of quitting drinking in relation to the onset of a variety of health conditions. Methods: Odds ratios (ORs) and 95% confidence intervals (CIs) of ceasing alcohol consumption after diagnosis of 28 health conditions and 4 general indicators of health were derived from logistic regression among 97,852 drinkers aged ≥ 45 years between baseline (2006 to 2009) and median 5.3 years of follow‐up in the New South Wales 45 and Up Study. Incident health conditions at follow‐up were self‐reported. Results: At follow‐up, 9.6% (n = 9,438) of drinkers had ceased drinking. Drinking cessation was significantly associated with 24 of 32 health conditions examined: 15.4% of participants with newly diagnosed diabetes quit drinking (OR for quitting vs. continuing 1.77, 95% CI: 1.60 to 1.96), 16.4% with Parkinson's disease (1.71, 1.35 to 2.17), 17.8% with poor memory (1.68, 1.43 to 1.97), 19.2% with hip fracture (1.64, 1.30 to 2.06), 14.7% with stroke (1.45, 1.27 to 1.66), 12.5% with depression (1.40, 1.26 to 1.55), 15.0% with breast cancer (1.38, 1.18 to 1.61), 12.3% with heart disease (1.34, 1.25 to 1.44), and 13.3% with osteoarthritis (1.22, 1.12 to 1.33). Strong associations with quitting were observed in those with a decline in self‐rated overall health (2.93, 2.53 to 3.40) and quality of life (2.68, 2.24 to 3.21). Some health conditions not significantly associated with quitting were prostate cancer, melanoma, nonmelanoma skin cancer, hay fever, and hearing loss. Findings were generally consistent for men and women, by age group and by smoking status. Conclusions: Diagnosis with a variety of health conditions appears to prompt drinking cessation in older adults. Evidence suggests that people who develop serious health conditions are likely to cease drinking alcohol (sometimes known as 'sick–quitters'). We quantified the likelihood of quitting drinking in relation to the onset of a variety of health conditions among 97,852 Australian drinkers aged ≥45 years. Drinking cessation was significantly associated with 24 of 32 health conditions examined. This research adds to the evidence that 'sick‐quitters' can bias alcohol‐health associations in older age, and must be accounted for in epidemiological studies. [ABSTRACT FROM AUTHOR]