What Is Cardiovascular Disease?

Cardiovascular disease (CVD) refers to a group of conditions affecting the heart and blood vessels, including coronary artery disease, heart attack, stroke, heart failure, arrhythmias, and valvular heart disease. In Australia, CVD accounts for approximately one in four deaths and affects an estimated four million Australians. Despite these figures, a large proportion of cardiovascular events are preventable through early detection, risk factor management, and specialist cardiology care.

Risk Factors for Heart Disease

Many cardiovascular risk factors can be identified and modified well before symptoms develop. The most important modifiable risk factors include:

• High LDL cholesterol and dyslipidaemia — elevated low-density lipoprotein (LDL-C) drives atherosclerosis and is one of the most important targets in cardiovascular prevention.
• Hypertension (high blood pressure) — sustained elevated blood pressure damages arterial walls and significantly increases the risk of heart attack and stroke.
• Type 2 diabetes and insulin resistance — metabolic dysregulation accelerates vascular ageing and amplifies other cardiovascular risk factors.
• Smoking — tobacco use is one of the strongest independent risk factors for premature coronary artery disease.
• Physical inactivity and obesity — sedentary lifestyle and excess weight are closely linked to hypertension, diabetes, and abnormal lipid profiles.
• Family history — a first-degree relative with premature cardiovascular disease substantially increases personal risk, particularly in familial hypercholesterolaemia (FH).
• Elevated Lipoprotein(a) — Lp(a) is a genetically determined lipid particle increasingly recognised as an independent risk factor for atherosclerotic cardiovascular disease.

Cardiovascular Risk Assessment

The Australian Cardiovascular Disease Risk Calculator (CVDCheck) estimates an individual's five-year risk of a major cardiovascular event based on age, sex, smoking status, blood pressure, cholesterol, and diabetes status. A formal cardiovascular risk assessment by a specialist cardiologist goes further — integrating imaging findings such as coronary artery calcium (CAC) scoring, subclinical atherosclerosis markers, and family history to personalise prevention strategies.

At HeartWise Cardiology, Dr Tashi Zhaxiduojie (FRACP, PhD) provides comprehensive cardiovascular risk assessments for patients referred by their GP or other specialists. This includes evaluation of lipid profiles including LDL-C and Lp(a), blood pressure assessment, echocardiographic screening, and CT coronary calcium scoring where indicated. The aim is to identify high-risk individuals who may benefit from intensified lipid-lowering therapy, including PCSK9 inhibitors, before a clinical event occurs.

Preventive Cardiology at HeartWise

Preventive cardiology is a core focus at HeartWise Cardiology. The practice manages a range of conditions that increase cardiovascular risk, including familial hypercholesterolaemia, statin intolerance, elevated Lipoprotein(a), hypertensive heart disease, and subclinical coronary artery disease detected on calcium scoring. For patients who remain at high risk despite standard therapies, advanced lipid-lowering agents such as evolocumab (Repatha) and inclisiran (Leqvio) can be prescribed under PBS subsidy following specialist assessment.

Lifestyle modifications — including a heart-healthy diet (Mediterranean or DASH diet pattern), regular moderate-intensity physical activity, smoking cessation, and weight management — are always integrated into prevention plans. Evidence shows that consistent lifestyle changes can reduce cardiovascular risk by 30–50% independently of medication.

When to See a Cardiologist in Perth

A GP referral to a cardiologist is recommended if you have: persistently high cholesterol despite statin therapy, a family history of premature heart disease or sudden cardiac death, unexplained chest pain or breathlessness, palpitations or an irregular heartbeat, an abnormal ECG or echocardiogram, or a cardiovascular risk score above 15% over five years. Early specialist assessment allows for targeted investigation and treatment that can significantly reduce the risk of a future heart attack or stroke.

HeartWise Cardiology accepts referrals from GPs and other specialists at clinics across Perth — in Riverton, Joondalup, Nedlands, and Gosnells. To refer a patient, use the online referral portal or send via HealthLink (ID: hwisecrd).