Summary
Treatment thresholds for cardiovascular disease risk should be determined based on a person's age and calculated risk score. For Aboriginal and Torres Strait Islander peoples, screening should start at a younger age, around 18-34 years, as evidence shows cardiovascular disease starts earlier in this population and risk scores likely underestimate risk in this group. However, there is limited evidence on the extent of underestimation and alternative risk scores for this population. Risk scores should not be adjusted upward by a fixed 5% for all Aboriginal and Torres Strait Islander peoples. Instead, treatment thresholds should depend on a person's initial calculated risk score. For those at higher risk, more frequent monitoring and reassessment of risk, for example 6-12 monthly, is suggested based on guidelines, although optimal reassessment intervals are unclear. For lower risk individuals, reassessment every 2-5 years may be sufficient. Blood pressure targets of <140/90mmHg are recommended for most patients according to guidelines. However, for some high-risk groups, lower targets of <130/80mmHg are suggested to help reduce cardiovascular disease risk. Treatment should aim for the lowest possible blood pressure targets for each individual based on their risk profile and tolerance of medications. A risk-based approach to updating clinical guidelines is recommended. For recommendations where evidence is lacking or limited, exhaustive evidence reviews are not required. However, stakeholder input is important for reducing subjectivity. Re-evaluation of guidelines every 2-3 years is suggested for most recommendations, with some topics requiring more frequent monitoring and updating as new evidence emerges. An online 'living guidelines' model with continuous updating may be useful, especially if linked to decision support tools. However, this requires significant resources and commitment to evaluating new evidence and updating recommendations. In summary, treatment thresholds and targets for cardiovascular disease risk management should be determined based on a person's age, risk score, blood pressure, and other risk factors. A risk-based approach to clinical guidelines and recommendations allows for tailored management based on individual risk profiles. For high-risk groups, earlier and more intensive management is required to help reduce cardiovascular disease risk.
Cardiovascular diseases are the leading cause of death worldwide. Machine learning can be used to create a non-invasive, low-cost system to accurately predict the risk of developing CVDs.
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The text discusses reports about guidelines for cardiovascular disease risk in Aboriginal people. Guidelines differ on screening age, risk score adjustment, reassessment frequency and blood pressure targets. Evidence shows Aboriginal people have equivalent risk at younger ages. Scores likely underestimate their risk but data lacks. No evidence supports 5% adjustment. Risk reassessment depends on risk level but best intervals unclear. Blood pressure targets aim to reduce CVD; some recommend under 140/90mmHg, others 130/80mmHg.
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