title: How do the Australian guidelines for lipid-lowering drugs perform in practice? Cardiovascular disease risk in the AusDiab Study, 1999-2000.
abstract: OBJECTIVE
  To determine how well the current Pharmaceutical Benefits Scheme (PBS) eligibility criteria for subsidy of lipid-lowering drugs compare with current national guidelines for determining the population at high risk of developing cardiovascular disease (CVD).
  
  
  METHODS
  Analyses of the population-based, cross-sectional Australian Diabetes, Obesity and Lifestyle (AusDiab) study, conducted in 1999-2000. The 1991 Framingham risk prediction equation was used to compute 5-year risk of developing first-time CVD in 8286 participants aged 30-74 years with neither CVD nor diabetes. Based on the National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines, people with either 5-year CVD risk > or = 15% or with 5-year CVD risk of 10%-< 15% and the metabolic syndrome were defined as having estimated high absolute CVD risk.
  
  
  METHODS
  5-year CVD risk; estimated population with high CVD risk.
  
  
  RESULTS
  Among participants without prevalent CVD or diabetes, 7.9% of men and 1.5% of women had a 5-year CVD risk > or = 15%. Of the estimated residential Australian population in 2000 aged 30-74 years without CVD or diabetes, 717 000 people were considered to be at high absolute CVD risk. Among the high-risk AusDiab participants without CVD or diabetes, only 16.9% of men and 15.4% of women were being treated with lipid-lowering drugs. Of the 9.6% of participants free of CVD and diabetes who were untreated but eligible for subsidy under PBS criteria, only 27.4% had an estimated high absolute CVD risk.
  
  
  CONCLUSIONS
  Strategies for CVD prevention using lipid-lowering medications can be improved by adoption of the absolute-risk approach.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Sophie L
authors.initials: SL
authors.lastname: Rogers
authors.forename: Stephen
authors.initials: S
authors.lastname: Colagiuri
authors.forename: Dominique A
authors.initials: DA
authors.lastname: Cadilhac
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Mathew
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Boyden
authors.forename: Anna
authors.initials: A
authors.lastname: Peeters
authors.forename: Dianna J
authors.initials: DJ
authors.lastname: Magliano
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Shaw
authors.forename: Paul Z
authors.initials: PZ
authors.lastname: Zimmet
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tonkin
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment
chemical_list: D000960:Hypolipidemic Agents