Background Heart age calculators are used worldwide to engage the public in cardiovascular disease (CVD) prevention. Experimental studies with small samples have found mixed effects of these tools, and previous reports of population samples that used web-based heart age tools have not evaluated psychological and behavioral outcomes. Objective This study aims to report on national users of the Australian heart age calculator and the follow-up of a sample of users. Methods The heart age calculator was launched in 2019 by the National Heart Foundation of Australia. Heart age results were calculated for all users and recorded for those who signed up for a heart age report and an email follow-up over 10 weeks, after which a survey was conducted. CVD risk factors, heart age results, and psychological and behavioral questions were analyzed using descriptive statistics and chi-square tests. Open responses were thematically coded. Results There were 361,044 anonymous users over 5 months, of which 30,279 signed up to receive a heart age report and 1303 completed the survey. There were more women (19,840/30,279, 65.52%), with an average age of 55.67 (SD 11.43) years, and most users knew blood pressure levels (20,279/30,279, 66.97%) but not cholesterol levels (12,267/30,279, 40.51%). The average heart age result was 4.61 (SD 4.71) years older than the current age, including (23,840/30,279, 78.73%) with an older heart age. For the survey, most users recalled their heart age category (892/1303, 68.46%), and many reported lifestyle improvements (diet 821/1303, 63.01% and physical activity 809/1303, 62.09%). People with an older heart age result were more likely to report a doctor visit (538/1055, 51.00%). Participants indicated strong emotional responses to heart age, both positive and negative. Conclusions Most Australian users received an older heart age as per international and UK heart age tools. Heart age reports with follow-up over 10 weeks prompted strong emotional responses, high recall rates, and self-reported lifestyle changes and clinical checks for more than half of the survey respondents. These findings are based on a more engaged user sample than previous research, who were more likely to know blood pressure and cholesterol values. Further research is needed to determine which aspects are most effective in initiating and maintaining lifestyle changes. The results confirm high public interest in heart age tools, but additional support is needed to help users understand the results and take appropriate action.

Background and objectiveApproximately 65% of cardiovascular disease (CVD)-related deaths in Australia occur in people with diabetes or pre-diabetes. The aim of this study was to investigate general practice management of risk factors among patients with both conditions. MethodsThis was a cross-sectional study of 33,559 adult patients with both type 2 diabetes and CVD at 1 November 2018, using the general practice data program MedicineInsight. ResultsOne-third of patients did not have a record in their current medications list for all three recommended medicines to reduce cardiovascular risk. Potentially suboptimal monitoring and achievement of targets for diabetes and cardiovascular risk factors was also identified. Most patients using metformin-based combination therapy were prescribed blood glucose-lowering medicines that do not have evidence of cardiovascular benefit. DiscussionThese data suggest opportunities to support general practices to optimise patient management. Datasets such as MedicineInsight can help practices identify patients who may benefit from recall.APPROXIMATELY 65% of all cardiovascular disease (CVD)-related deaths in Australia occur in people with diabetes or pre-diabetes. 1 The mortality rate in people with type 2 diabetes (T2D) almost doubles with the coexistence of CVD, resulting in an estimated 12-year reduction in life expectancy. 2 Typically, people with T2D experience atherosclerotic CVD earlier and with greater severity than people without T2D. 3 Despite their significantly elevated risk, suboptimal prescribing of blood pressure (BP)-lowering, 4,5 lipid-modifying 4-6 and antiplatelet therapy 5 for patients with diabetes and CVD has been reported in Australian primary care. Australian data also show that many patients with diabetes and/or CVD do not meet guideline recommendations for prescribing, 4-10 monitoring and treatment targets for managing cardiovascular risk. 5,7 Blood glucose-lowering medicine (GLM) selection is also increasingly complex because of the increase in available medicines, and the focus on cardiovascular safety since the US Food and Drug Administration mandated in 2008 that all new studies must demonstrate cardiovascular safety. 11 Several trials have shown not only cardiovascular safety, but also additional cardiovascular and renal benefits over placebo. [12][13][14][15][16][17][18][19][20] The aim of this study was to investigate management of T2D and atherosclerotic CVD risk factors in general practice, using MedicineInsight data to explore medicines prescribed, monitoring performed and achievement of treatment targets. The study was part of a quality improvement program that ran from June 2018 to April 2019 and involved presenting practicelevel data to general practitioners (GPs) at small group meetings to identify opportunities for improvement in clinical care. MethodsA cross-sectional study was conducted using MedicineInsight, a large national general practice database developed and managed by NPS MedicineWise, with funding support from the Australian Gover...

Dyslipidaemia is a major risk factor for cardiovascular disease (CVD) and is routinely managed by GPs. Lipid-modifying medicines, commonly statins, are used to treat dyslipidaemia and prevent CVD in high-risk individuals. A national education program for over 8000 Australian GPs was delivered and evaluated. The program aimed to optimise the use of statins and provide GPs with an Australian-developed statin-associated muscle symptoms (SAMS) management algorithm supporting assessment and management of suspected SAMS. Retrospective pre-test and control questionnaires were administered to measure changes in knowledge and intended practice following the education program. A total of 226 participant GPs and 150 control GPs completed the questionnaires. The program led to positive changes in GP knowledge and intended practice around the use of absolute CVD risk to make prescribing decisions. Participant GPs demonstrated increased knowledge, compared with control GPs, about the use of CVD risk calculators as the most effective approach to lipid management, and adequately trialling a statin before considering a second agent. One of the greatest improvements in participant GP-intended practice related to the assessment and management of suspected SAMS, with participant GPs more likely to appropriately identify and manage suspected SAMS than control GPs.

A critical aspect of coronary heart disease (CHD) care and secondary prevention is ensuring patients have access to evidence-based information. The purpose of this review is to summarise the guiding principles, content, context and timing of information and education that is beneficial for supporting people with CHD and potential communication strategies, including digital interventions. We conducted a scoping review involving a search of four databases (Web of Science, PubMed, CINAHL, Medline) for articles published from January 2000 to August 2022. Literature was identified through title and abstract screening by expert reviewers. Evidence was synthesised according to the review aims. Results demonstrated that information-sharing, decision-making, goal-setting, positivity and practicality are important aspects of secondary prevention and should be patient-centred and evidenced based with consideration of patient need and preference. Initiation and duration of education is highly variable between and within people, hence communication and support should be regular and ongoing. In conclusion, text messaging programs, smartphone applications and wearable devices are examples of digital health strategies that facilitate education and support for patients with heart disease. There is no one size fits all approach that suits all patients at all stages, hence flexibility and a suite of resources and strategies is optimal.

No abstract