1. The 2009 New Zealand Cardiovascular Guidelines Handbook What’s new?

2.  NZGG has updated the Cardiovascular Guidelines Handbook.  There are several changes that may affect day-to-day practice.

3. Cardiovascular Risk charts  Ages bands on the risk charts now state an age range (i.e. 55–64 years), instead of choosing the age closest to the patient (i.e. 60 years)  Only systolic blood pressure is required for the calculation of risk Charts are now easier to use

4. Non-fasting bloods may be collected  Fasting blood tests remains recommended practice  Non fasting bloods may be used for: –Chol/HDL ratio –HbA1c Do non-fasting bloods instead of risking losing a patient

5. Renal disease recognised  People with CKD begin risk assessments 10 years earlier  ACR (albumin:creatinine ratio) and eGFR can be used for assessing renal function

6. Lipids target lowered  More aggressive treatment may be required  Optimal targets for lipids for those at higher risk changed: –LDL now < 2.0mmol/L (was < 2.5 mmol/L) –Chol/HDL ratio now < 4.0 (was < 4.5) –Cholesterol < 4.0 mmol/L (no change)

7. New blood pressure target for CKD  More aggressive treatment of BP may be required for people with CKD.  Target < 125/75 mmHg for all people with chronic kidney disease.

8. Change to frequency of CVD risk assessment  Update recalls for people with a CVD risk of 10–15%  For people with a CVD risk of between 10–15%, recheck every 2 years (was every 5 years).

9. New Zealand Cardiovascular Guidelines Handbook 2009 Edition. Available from: www.nzgg.org.nz (downloadable online version plus order form for hard copy). www.nzgg.org.nz