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Absolute risk of cardiovascular disease events, and blood pressure- and lipid-lowering therapy in Australia

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Cardiovascular disease (CVD) is the leading cause of morbidity and mortality internationally.1,2 A large proportion of CVD events are preventable by appropriate population-level interventions and individual management of risk. The potential for benefit, the balance of benefits and harms, and the cost-effectiveness of treatments to reduce CVD events are more closely related to an individual’s absolute CVD risk — the absolute probability that they will experience a CVD event in a given time period — than to isolated individual risk factors or relative risks.3,4

Accurate assessment of absolute CVD risk applies quantitative data on multiple factors that influence risk, including smoking status, blood pressure (BP), blood lipid levels, and diabetes status, to a person’s age- and sex-specific background level of absolute risk.3 Assessment that is based only on individual risk factors (eg, considering cholesterol levels alone) and does not use tools that allow quantification of overall absolute CVD risk leads to substantial misclassification, a general underestimation of risk, and under- and overtreatment.5 Quantitative absolute risk models that assess risk and guide management are central…