This study states that Cardiovascular disease (CVD) prevention guidelines recommend the use of absolute CVD risk, based on multiple risk factors, to guide clinical management. Australian guidelines recommend using a 5-year Framingham risk equation based on age, sex, smoking status, diabetes, systolic blood pressure and cholesterol to predict absolute CVD risk. Patients with a score >15% are classified as high risk and recommended for simultaneous blood pressure and cholesterol lowering therapy in addition to lifestyle modification (1). Absolute CVD risk management has a favourable risk–benefit ratio for preventing CVD events compared with single risk factor management. Despite this, there is poor implementation of guidelines, with limited screening of absolute CVD risk and a focus on single risk factor management (e.g. only focussed on lipids or blood pressure), resulting in missed opportunity to effectively manage CVD risk in primary care (9–12).

Previous attempts to improve implementation of absolute CVD risk in Australia focussed on electronic tools, such as CVD risk calculators, integrated with existing medical software and decision aids to support management (13–16). These interventions have had limited success, perhaps due to barriers including lack of time to conduct absolute CVD risk assessment, lack of motivation to engage with absolute CVD risk or lack of knowledge of CVD prevention guidelines.

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