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Feature Article

Treating-to-risk: an approach to managing absolute CVD risk and hypertension

Christian Hamilton-Craig, Anne L Tonkin

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Abstract

How can you accurately assess a patient’s risk of cardiovascular disease (CVD)? When do you decide to treat a patient’s blood pressure? What about younger patients with raised blood pressure, and what about the elderly? This article looks at CVD risk calculation and issues about hypertension treatment in general practice.

Key Points

  • The use of absolute risk calculations allows us to identify patients at high cardiovascular disease (CVD) risk who will benefit most from antihypertensive treatment.
  • Identify and treat all risk factors; the combined risk from multiple risk factors is greater than would be expected from simply adding them up, even if each risk factor is relatively minor.
  • Recent trial evidence shows that intensive blood pressure control is beneficial, especially for groups at high CVD risk.
  • Absolute risk charts are a useful source of information to help patients understand their CVD risk profile.
  • Remember nonpharmacological approaches to reducing CVD risk: a structured plan may involve referral to other health professionals, with therapy tailored to the individual patient’s needs.

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