Cardiovascular health
Protecting your heart — what really matters
Most people think heart disease is about bad luck or bad genes. Some things are out of our control — age, family history, sex, and ethnic background all play a role. But a large international study found that nine everyday factors explain over 90% of the risk of a heart attack. Your daily choices usually matter more than your DNA.
Prevention is much easier when it starts early — ideally from age 30.
Risk factors you can and can't control
Things you cannot change
Age (men over 45, women over 55)
Family history of early heart disease
Sex (men at higher baseline risk)
Ethnic background (Aboriginal, Torres Strait Islander, South Asian, Pacific Islander)
Things you can change
High LDL ("bad") cholesterol
Type 2 diabetes and high blood sugar
Excess weight, especially around the waist
Poor diet, inactivity, stress, excess alcohol
Understanding your personal risk — QRISK3
We use the QRISK3 calculator to estimate your individual risk based on age, sex, ethnicity, cholesterol, blood pressure, smoking history, diabetes, and other factors — giving both a 10-year and lifetime risk estimate.
Low risk
Under 10% (10-yr) or lifetime risk under 39%
Focus on healthy lifestyle. Medication not required.
Target LDL: below 3.0 mmol/L
Moderate risk
10–20% (10-yr) or lifetime risk over 39%
Strong lifestyle focus. Medication may be considered.
Target LDL: below 2.5 mmol/L
High risk
Over 20% (10-yr risk)
Medication (statins, BP tablets) strongly recommended alongside lifestyle changes.
Target LDL: below 1.8 mmol/L
Risk may be reclassified higher if you have elevated lipoprotein(a), very low HDL cholesterol, or signs of disease on cardiac scans.
Investigations
Coronary calcium score (CAC)
~$400 · Not Medicare covered
Low-dose CT scan measuring calcium in heart arteries. Most useful in moderate-risk patients where the decision to start a statin is unclear. Usually a one-time test.
Stress echocardiogram
~$500 · Medicare rebate available
Assesses heart function under stress. Used for symptoms such as chest pain, breathlessness, or palpitations — not a routine screening test.
Coronary CT angiography (CTCA)
Up to $800 · Rebate if referred by specialist
Shows both calcified and soft plaques inside heart arteries. More detailed than a calcium score. Useful in intermediate-risk or unclear cases.
Coronary angiogram
Hospital-based · Always via cardiologist
The most detailed view of heart artery blockages. Not a screening test — used when high risk or other tests suggest significant disease.
The take-home message
Know your numbers — cholesterol, blood pressure, and blood sugar
Don't smoke. Stay active. Eat plenty of plants and less processed food
Manage stress, sleep well, and keep alcohol in check
If your risk is moderate or high, statins and blood pressure tablets are powerful protective tools
Small changes from age 30 can prevent a heart attack decades later