GP tools to cut CVD risks

A new toolkit is helping GPs calculate CVD risks in their patients, as the Heart Foundation’s Natalie Raffoul explains. 


An estimated 340,000 West Australians live with cardiovascular disease. On average, 150 people are hospitalised each day with heart, stroke and blood-vessel disease and nine people die from these conditions.

Heart Foundation’s Natalie Raffoul

In outback North-West, hospital stays for heart attack are more than double those of the Wheatbelt – just one of the differences in heart health outcomes seen in WA.

But, while the challenges in addressing CVD are big, so are the opportunities to detect and manage those at risk.   

Too many times we hear of people who think they’re fine but don’t realise they’re a ticking time bomb. For many, it is not uncommon for a heart attack or stroke to be the first sign of something seriously wrong. 

Modifiable CVD risk factors account for 90% of heart attack risk, reinforcing the fact that CVD is largely preventable.

We know that high blood pressure and high cholesterol are two of the biggest risk factors for heart attack and stroke. These conditions are often silent or symptom free but are largely preventable and treatable if they’re picked up and managed. 

In WA, more than 600,000 adults have hypertension, more than 730,000 have high cholesterol, 1.2 million are living with obesity, 1.5 million are not active enough and more than 255,000 smoke. 

General practice teams, not only in WA but right across the country, play a pivotal role in the fight against CVD. 

The impact of COVID-19 on chronic disease prevention remains untold, but data shows that many Australians postponed health services in the past 18 months, from emergency treatment of acute conditions to preventive health assessments like Heart Health Checks. 

The Heart Health Check is the first preventative health assessment MBS item (699 or 177) to incorporate absolute CVD risk calculation and facilitation of yearly assessment. 

This absolute assessment brings together the combined risk of multiple CVD risk factors to estimate a person’s chance of heart attack or stroke in the next five years. 

General practice staff have many tasks to juggle and require simple and practical tools when it comes to assessing cardiovascular risk and managing it, which is where the Heart Foundation’s Heart Health Check Toolkit comes in. 

The toolkit was developed with involvement of a national primary care expert advisory group, while a broader general practice validation group tested and reviewed the resource to ensure it was both practical and relevant.

It is a combination of online tools to support the systematic implementation of Heart Health Checks via a whole-of-practice approach. Including:

  • Templates: Pre-filled assessment and management forms make it is easier for GPs and practice nurses to collect CVD risk factor information and support patients to manage their risk in line with clinical guidelines.
  • Recall guidance: Patient invitation templates, a receptionist’s guide and data recall recipes help general practice teams to identify and reach out to at-risk patients.
  • Patient resources: Waiting room posters, animations and brochures are available to engage and motivate patients about their heart health. 
  • Quality improvement tips: Kickstart continuous activities relating to CVD risk as per the PIP QI program and gain financial incentives.

By making the Heart Health Check easier to plan and implement, the toolkit aims to encourage the integration of these checks into routine patient care to help lower the sickness and death from CVD in Australia. 

ED: Natalie Raffoul is the Heart Foundation’s National Risk Reduction Manager. She acknowledges the assistance of co-ordinator Sophie Gohl in the writing of this column.