Patients at risk of heart attacks or stroke missing out on medication

Lindy Kerin reported this story on Monday, May 2, 2016 12:45:57

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ELEANOR HALL: A study has found that more heart attacks and strokes could be prevented if Australians receive the right combination of medication.

One in five Australians aged between 45 and 74 are at a high risk of heart attack or stroke.

But around one million of them are not receiving the recommended combinations of medications.

Lindy Kerin has been asking why.

LINDY KERIN: Cardiovascular disease is one of the country's leading causes of death.

EMILY BANKS: We have around 100,000 Australian's diagnosed with Cardiovascular Disease every year. That's about one Australian every five minutes has a heart attack or a stroke, so it's incredibly common.

LINDY KERIN: That's Professor Emily Banks from the Australian National University's Centre for Epidemiology and Population Health.

She's the lead author of a new study that's found one in five Australians between the ages of 45 and 74 are at high risk of a heart attack or stroke within the next five years.

EMILY BANKS: Twenty percent of the Australian population aged 45 to 74 are at high risk of cardiovascular disease and that's around 1.4 million individuals. We also know from our findings that around a million of those people are not taking the currently recommended bloody pressure and cholesterol lowering medication. So those are the figures.

There's about a million people in that age group 45 to 74 alone who are at high risk - that is they've either had a heart attack or stroke in the past or they have a more than 15 per cent chance of having one in the next five years, and they're not taking that combination of blood pressure lowering and cholesterol lowering medication.

LINDY KERIN: The research published in the latest Medical Journal of Australia suggests more needs to be done to assess patients at risk.

EMILY BANKS: There's a big gap between what's currently happening and what needs to happen, and the reasons for that gap likely to be multiple.

So the first thing is that people in the general community are not aware of their level of risk. It's not something you can tell buy yourself. So people if they're 45 or over in the general community; or 35 over if they're Aboriginal or Torres Strait Islander, they need to attend their General Practitioner or other heath professional to have their risk assessed.

The second thing is that General Practitioners need to be in a really good position to do this full risk assessment. We know that actually that's not being done absolutely consistently in general practice. So general practitioners need to be supported to do that.

And the final thing is, when people are recommended these treatments they do need to really seriously consider taking them and if they are taking them they generally need to take them long term.

LINDY KERIN: The findings are a wakeup call, according to the Heart Foundation's national chief medical advisor Professor Garry Jennings.

GARRY JENNINGS: The results are really quite disturbing, because this is a very preventable disease and it's a major killer and cause of disability in Australians.

LINDY KERIN: Professor Jennings agrees better assessments and an increase in community awareness will help reduce the number of patients at risk.

GARRY JENNINGS: Obviously we want the whole community to focus on the things that they can do to prevent future heart attacks and strokes, and that's mainly through a healthy lifestyle; good nutrition, remaining physically active, avoiding getting overweight.

But then they also need to know about some things that you can't tell about yourself; that is, things like your blood pressure, your blood fats, whether you've got diabetes or not. They need some tests and that where this absolute risk test, which is recommended for all Australian's been 45 and 74, and Aboriginal and Torres Strait Islanders over the age of 35 comes in.

What an absolute risk test does is it brings together all the various risk factors, because some people don't have a particularly high level of any one risk factor but when you put them all together it adds up to a significant future likely problems. So actually having the test is most important and every GP can and should be doing this.

LINDY KERIN: So why isn't that happening now? Are doctors not using that test?

GARRY JENNINGS: We're certainly not seeing high rates of absolute risk testing in the community at the moment. It's a little hard to know why, but I think it's not- this suggests that it's not front of mind, either, in the general population who are attending general practitioners or in practices themselves.

I'm sure there are places where it's being done very well, but on the whole we're not meeting those reasonable national targets.

ELEANOR HALL: That's professor Garry Jennings from the Heart Foundation speaking to Lindy Kerin.

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