Experts say thousands at risk for heart disease go unchecked

Sep 15 2008

Australian experts say thousands at risk for heart disease go unchecked and are not getting the drugs which protect them.

A study by medical advisers from the Heart Foundation, National Stroke Foundation, Diabetes Australia and Kidney Health Australia, has revealed that as many as 500,000 high-risk people are not receiving the medications they need because of an over reliance on measures such as checking for high cholesterol and blood pressure levels.

They believe this blanket reliance hampers the identification of people whose disease risk is greatly elevated because of a combination of other factors such as advancing age, being male and smoking.

The study leader Professor Andrew Tonkin says he has found that cholesterol-lowering drugs have not been prescribed to more than 80% of people judged to have a 15% or greater risk of having a heart attack, stroke or other form of heart disease in the coming five years.

Professor Tonkin, who is a cardiologist and head of the Cardiovascular Research Unit at Monash University, says although the results were based on re-analysis of the last national disease risk survey, the Australian Diabetes, Obesity and Lifestyle (AusDiab) study, conducted in 1999–2000, there remains an under treatment of people with non-modifiable high risk factors such as age and sex.

The specialists found a healthy man's risk of developing heart disease was more than three times as great as a woman's, but for both sexes the chance of having a first heart attack or other dangerous circulatory problem in the following five years escalated dramatically through middle age, quadrupled for men between their 40s and 60s and increased ten times for women.

Professor Tonkin says the idea that people either have high cholesterol and high blood pressure, or do not, is a spurious notion as only about a quarter of heart attacks or strokes occur in people with the highest cholesterol levels and most heart attacks and strokes were attributable to "the interplay and intensity of risk factors".

The study found that while 717,000 Australians without diabetes or heart disease fell into the high-risk category, only about a quarter of them had started taking the so-called statin drugs, such as Lipitor and Zocor.

They have called on the Federal Government to overhaul the way heart disease is assessed and treated and are in the process of developing guidelines to help doctors consider multiple factors when deciding whether to prescribe the drugs.

Statins are the most widely prescribed drugs in Australia and already cost the Pharmaceutical Benefits Scheme more than $1 billion a year.

The study is published in the Medical Journal of Australia.