YI 2.6 Comparison of Cardiovascular Disease Primary Prevention Guidelines between Australia, England and the United States

Niamh Chapman; Monique Breslin; Sarah Lay-Flurrie; Zhen Zhou; James Sharman; Mark Nelson; Richard McManus

doi:10.2991/artres.k.201209.014

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Volume 26, Issue Supplement 1, December 2020, Pages S19 - S19

YI 2.6 Comparison of Cardiovascular Disease Primary Prevention Guidelines between Australia, England and the United States

Authors

Niamh Chapman¹^{, *}, Monique Breslin¹, Sarah Lay-Flurrie², Zhen Zhou¹, James Sharman¹, Mark Nelson¹, Richard McManus²

¹University of Tasmania, 1Menzies Institute for Medical Research

²University of Oxford, 2Nuffield Department of Primary Care Health Sciences

^*Corresponding author. Email: niamh.chapman@utas.edu.au

Corresponding Author

Niamh Chapman

Available Online 31 December 2020.

DOI: 10.2991/artres.k.201209.014 How to use a DOI?
Keywords: Lipid; hypertension; obesity
Abstract: Objective: Cardiovascular disease (CVD) primary prevention guidelines recommend absolute CVD risk estimation to guide blood pressure and lipid therapy recommendations but are inconsistent despite relying on similar evidence. This study aimed to compare the populations recommended for treatment according to guidelines in Australia, England and the United States.

Methods: Cross-sectional analysis of national health survey data from Australian, English and United States (n = 4,056; n = 2,994; n = 2,943; respectively) adults aged ≥40 years. Participants were classified as recommended for therapy based on clinical characteristics denoting high risk and absolute CVD risk stratification according to each country’s guidelines [1–6]. Agreement in therapy recommendation assessed by Kappa statistic.

Results: Agreement in therapy recommendation was minimal to weak (κ = 0.35–0.54). Proportions recommended for either blood pressure or lipid lowering treatment ranged between 26–32%, 47–52% and 43–47% in Australia, England and United States. There was minimal to strong agreement in therapy recommendation according to clinical criteria (κ = 0.38–0.83) and minimal to moderate agreement according to absolute CVD risk (κ = 0.28–0.64) across guidelines.

Conclusion: Despite similar evidence apparently underpinning guidance, there is little agreement in the populations targeted for CVD primary prevention with Australia recommending far few people for treatment in comparison to England or the United States. This is due to differences in both clinical characteristics considered high risk and absolute CVD risk stratification. Whilst different countries may adopt different policies on the appropriate level of risk to target, these findings suggest a need to develop international consensus definition for high CVD risk in primary prevention guideline
Copyright: © 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

REFERENCES

[1]NVDPA, Guidelines for the management of absolute cardiovascular disease risk, 2012.

[2]GM Gabb, AA Mangoni, CS Anderson, D Cowley, JS Dowden, J Golledge, et al., Guideline for the diagnosis and management of hypertension in adults — 2016, Med J Aust, Vol. 205, 2016, pp. 85-9.

[3]NICE, Hypertension in adults: diagnosis and management, NICE guideline [NG136], 2019.

[4]NICE, Cardiovascular disease: risk assessment and reduction, including lipid modification, Clinical guideline [CG181], 2014.

[5]PK Whelton, RM Carey, WS Aronow, DE Casey, KJ Collins, C Dennison Himmelfarb, et al., 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines, J Am Coll Cardiol, Vol. 71, 2018, pp. e127-e248.

[6]DK Arnett, RS Blumenthal, MA Albert, AB Buroker, ZD Goldberger, EJ Hahn, et al., 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease : a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines, Circulation, Vol. 140, 2019, pp. e596-e646.

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Journal: Artery Research
Volume-Issue: 26 - Supplement 1
Pages: S19 - S19
Publication Date: 2020/12/31
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.201209.014 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

ris enw bib

TY  - JOUR
AU  - Niamh Chapman
AU  - Monique Breslin
AU  - Sarah Lay-Flurrie
AU  - Zhen Zhou
AU  - James Sharman
AU  - Mark Nelson
AU  - Richard McManus
PY  - 2020
DA  - 2020/12/31
TI  - YI 2.6 Comparison of Cardiovascular Disease Primary Prevention Guidelines between Australia, England and the United States
JO  - Artery Research
SP  - S19
EP  - S19
VL  - 26
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.201209.014
DO  - 10.2991/artres.k.201209.014
ID  - Chapman2020
ER  -

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