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Lost in translation: the gap between what we know and what we do about cardiovascular disease

An estimated one million Australians at high risk may not have been receiving recommended preventive treatments

We still seem disappointingly distant from getting it right with disease prevention in Australia. An analysis of data from the 2011–12 Australian National Health Measures Survey reported in this issue of the MJA1 found that most respondents at high risk of cardiovascular disease (CVD) were not receiving the recommended combination of blood pressure-lowering and lipid-lowering medications. Applying these estimates to the general population, almost one million Australians at high risk may not have been receiving these treatments, although their use has long been recommended by the national peak body on the basis of level A evidence.

Perhaps the data are incorrect? While the response rate to the survey among those aged 45–74 years (47%) was lower than desirable, survey respondents would be expected to have better, not worse, treatment rates than non-respondents. It is also likely that self-reporting overestimates treatment levels. Perhaps the data reflect the prevalence of contraindications to recommended treatment? Again, this is unlikely: definite contraindications to lipid-lowering and blood pressure-lowering medications are very rare, and placebo-controlled trials have shown that only a small proportion of subjects taking statins experience symptomatic side effects.