New Zealand cardiovascular (CVD) risk management guidelines support targeted treatment to patients with a high 5-year CVD risk and recommend a 5% upward adjustment for some high-risk population subgroups. This study estimated the impact of these adjustments on eligibility for treatment in a primary care setting, using data from CVD risk assessments involving 23,709 patients visiting their primary care provider in Auckland, New Zealand, between 2002 and 2006. Baseline CVD risks were calculated with and without the 5% upward adjustment for family history of premature ischaemic CVD or for being of Mäori, Pacific or Indian subcontinent ethnicity. Baseline CVD risks were calculated for 23,693 patients (99.9%); 90% were aged between 35 and 74 years. Unadjusted risk scores revealed that 70% of patients were below the 10% 5-year risk threshold for specific individualised treatment; 11 % were between the 10 to 15% risk (recommended to receive individualised lifestyle counselling in general practice) and 19% had a >15% risk (recommended for drug treatment and referral to a dietician in addition to individualised lifestyle counselling). Over 25% of patients had a premature family history of CVD; 21% were Mäori, Pacific, or Indian subcontinent – adjusted risk scores increased the numbers eligible for drug treatment, intensive lifestyle management, and dietician referral by approximately 20% and individualised lifestyle assessment and counselling by 50%.
