Feature Article

The why, who and how of CHD prevention

Mark R Nelson, Andrew Tonkin



Absolute risk of coronary heart disease (CHD) is determined using all the major CHD risk factors, including age and gender, and is a better indicator than relative risk of those patients in whom intervention is appropriate. Various risk calculation tools exist to aid the accurate assessment of absolute risk.

Key Points

  • Identify all patients who have established vascular disease.
  • Use a tool to calculate the absolute risk of CHD in patients without established vascular disease, i.e. the risk of a patient having a vascular event over the ensuing five years.
  • Intervene with lifestyle advice based on smoking, nutrition, alcohol and physical activity (SNAP) in all patients, when appropriate.
  • Intervene with drugs and other therapies in addition to lifestyle advice for patients at high absolute risk, including those with established vascular disease.