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Primary prevention of cardiovascular disease: new guidelines, technologies and therapies

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Acontinuing trend in primary prevention of cardiovascular disease (CVD) in general practice has been the move away from managing isolated CVD risk factors, such as hypertension and dyslipidaemia, towards assessment and management of these factors under the banner of absolute CVD risk.1 This has been underscored by the publication of guidelines for assessment and management of absolute risk.2,3 These guidelines seek to consolidate various individual disease and risk factor guidelines, recognising CVD as a common end-disease pathway and, therefore, the benefit of taking a common absolute risk-based approach. The rationale behind adopting this approach can be summarised as follows:

  • Medication is best initiated in those most likely to benefit from it, and who therefore have a favourable risk-to-benefit ratio.

  • It is more cost-effective than intervention for single risfactors.

  • It avoids medicalisation of the low-risk population.

  • It better identifies those most likely to have covert CVD, avoiding costly additional investigations.

  • Beneficial therapeutic agents…