CVD Risk Assessing 90% of a country: the New Zealand experience

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Many countries recommend cardiovascular disease (CVD) risk assessment to reduce the likelihood of developing ischaemic heart and cerebrovascular disease. New Zealand's experience with CVD Risk assessment is an interesting case study. New Zealand established national guidelines for the assessment and management of CVD risk in 2003. Uptake of risk assessment for the eligible population was initially slow. However, with the introduction of a national Health Target in 2012, the proportion being risk assessed increased from 46% to 87% in 2015 and continues to rise (Figure 1) The key success factors for this increase, based on research with high performers, include:•Political support with CVD Risk Assessment being one of six national Health Targets for the Minister of Health. The target is to have 90% of the eligible population risk assessed in the last 5 years.•Clinical support and leadership at local, district and national levels, particularly amongst general practice.•Use of the whole general practice team and multi-practice facilitators•Supportive IT systems including electronic prompts, risk calculators integrated into computer systems and the active use of data/audit feedback to providers•Innovative approaches to accessing patients The gains, while largely positive, have not been without debate. For example, many assessments have been non-face to face, and some wonder about the level of follow up given the focus on assessment rather than management. The key development for 2015 is to shift from an adapted Framingham based risk equation to a New Zealand specific equation.