Preventing Cardiovascular Disease in Primary Care with POLAR
29 Sep 2025
It is responsible for more than 1.2 million hospitalisations each year, an average of 57,000 heart attacks, and costs the health system over $12.7 billion annually. Every 12 minutes, an Australian dies from CVD.Why prevention matters in general practice
General practice plays a vital role in preventing CVD by identifying and managing risk factors early. The National Preventive Health Strategy 2021–2030, RACGP Guidelines, and PIP QI measures all recommend using absolute CVD risk assessments to guide care.
Modifiable risk factors such as smoking, obesity, high blood pressure, high cholesterol, poor diet, and physical inactivity can all be addressed through early intervention. However, data shows documentation in general practice is still limited:
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Less than half (49.8%) of eligible patients aged 45–74 without known CVD had enough information recorded to calculate an absolute risk score (AIHW 2021–22).
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Only 22.7% of patients aged 15+ had a recorded BMI, and 64.7% had an updated smoking status (AIHW 2014).
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In South Western Sydney, POLAR data shows only 43% of eligible patients have a documented CVD risk score.
How practices can improve
To strengthen CVD prevention, practices can:
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Record BMI (height and weight) annually.
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Review smoking status at least once a year, updating records if behaviour changes.
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Use these data points to calculate absolute CVD risk, provide lifestyle advice, and refer patients to programs such as smoking cessation services or the HEAL program.
How POLAR supports better outcomes
POLAR provides practices with tools to:
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Identify patients eligible for CVD risk assessment.
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Detect missing data such as blood pressure, cholesterol, or smoking status.
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Monitor improvements over time through quarterly comparisons.
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Work with PHN teams in Model for Improvement (MFI) sessions.
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Use the Private Bookmark function for quick access to relevant reports.
Key POLAR reports include:
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QIPC Clinic Report – CVD module: highlights patients’ risk documentation status and improvement opportunities.
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PIP QI report: tracks progress against national measures, including CVD risk factors.
Medicare support – Heart Health Checks
MBS Items 699 and 177 support annual Heart Health Checks for patients aged 45+ (or 30+ for First Nations patients). These checks cover history, blood pressure, cholesterol, and risk management planning. From July 2023, restrictions on co-claiming with First Nations health assessments were removed, allowing greater flexibility.
Support available from your PHN
Your local PHN can assist practices by offering:
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Training on CVD risk assessment and POLAR use.
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Heart Health toolkits with practical guides.
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Data reviews to identify gaps and track progress.
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Regular MFI meetings and follow-ups.
Useful resources
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AIHW – Burden of CVD in Australia
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Heart Foundation – Heart Health Checks
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CVD Check Tool
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RACGP – CVD Guidelines for Health Professionals
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NPS MedicineWise – Absolute CVD Risk in Practice
For more information about CVD prevention with POLAR or SWSPHN’s QIPC program, email cqisupport@swsphn.com.au or visit Quality Improvement in Primary Care.
Source: Heart Research Institute 2024; AIHW; RACGP; Heart Foundation; SWSPHN.
