Five-yearly absolute CVD risk assessment for primary prevention, using the 2023 Australian risk equation (cvdcheck.org.au) — not the older Framingham-based tool it replaced. Skip the calculator and manage as high risk directly where that's already clinically determined.
1Who & when to assess
✓General population — Adults 45–79 without known CVD or diabetes; assess every 5 years, more often if risk is borderline or rising.
✓Diabetes — From age 35, using the diabetes-specific risk equation (incorporates age at diagnosis, HbA1c and eGFR).
✓First Nations peoples — From age 30; individual risk factors may prompt earlier assessment from age 18–29.
✓Skip the calculator if — Known CVD (any prior event) or a clinically-determined high-risk condition — manage as high risk directly, without calculating a percentage.
2Risk categories & what each triggers
| Category | 5-year risk | Action & review |
|---|
| High | ≥10% | Discuss lifestyle + pharmacotherapy (BP- and lipid-lowering) now; review annually |
| Intermediate | 5–<10% | Lifestyle first; consider pharmacotherapy if patient preference or a reclassification factor is present; review 1–2 yearly |
| Low | <5% | Lifestyle advice; review every 5 years |
Reclassification factors — can move a patient up a risk band: coronary artery calcium (CAC) score, family history of premature CVD (<65 in women, <55 in men), South Asian ethnicity, and severe mental illness. None of these are entered into the calculator itself — apply clinical judgement on top of the calculated percentage.
3What the calculator needs
- Demographics: age, sex, postcode (used as a socioeconomic proxy), and First Nations status.
- Smoking status — current smoker is a yes/no input, not pack-years.
- Systolic blood pressure — most recent reading, ideally out-of-clinic.
- Total and HDL cholesterol — fasting not required for the current equation.
- Diabetes status, with HbA1c and eGFR if present.
- Current medicines — antihypertensives and lipid-lowering therapy (the calculator adjusts for treatment already in place).
- Atrial fibrillation history.
Safety
- CKD with eGFR<45, or significant albuminuria.
- Familial hypercholesterolaemia, clinically diagnosed or suspected.
- BP persistently ≥180/110 mmHg.
- Total cholesterol >7.5 mmol/L.
Check / exclude
- Known CVD always excludes calculator use — manage as secondary prevention regardless of any score.
- Always run the assessment on the official calculator at cvdcheck.org.au — this sheet is a summary, not a substitute.
- Confirm current thresholds and the diabetes-specific equation inputs at cvdcheck.org.au before relying on a result.
CV-01B v1.0 · Reviewed Jun 2026 · Review Dec 2026
For health-professional use. Framework: 2023 Australian Guideline for assessing and managing cardiovascular disease risk (Heart Foundation / ACDPA), endorsed by RACGP. Run the actual assessment at cvdcheck.org.au — figures and cut-offs here are a summary, not a substitute. Companion sheet: CV-01 Hypertension Management.
