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Cohen's kappa and Bland\u2013Altman plots were used to assess agreement and concordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Using the 2023 CVD risk algorithm and revised thresholds, 9.7% of participants were at high CVD risk (\u2265\u200910% 5\u2010year risk or clinically determined high risk); 26.4% were at intermediate CVD risk (5% to &lt;\u200910% 5\u2010year risk) and 63.9% were at low CVD risk (&lt;\u20095% 5\u2010year risk). Corresponding 2012 figures for CVD risk were 17.6% high (&gt;\u200915% 5\u2010year risk or clinically determined high risk), 11.6% intermediate (10%\u201315% 5\u2010year risk) and 70.8% low (&lt;\u200910% 5\u2010year risk). Differences in proportions at high risk were largely driven by changes to clinically determined criteria for high risk. Overall, there was moderate\u2010to\u2010substantial agreement (linear\u2010weighted kappa\u2009=\u20090.62) and concordance (Kendall's tau\u2010\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20090.74) between algorithms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Proportions estimated at low risk and not routinely recommended pharmacotherapy align with international standards and were similar between guidelines. Although fewer people would be recommended pharmacotherapy due to being high risk under the updated versus previous guidelines, this likely reflects more accurate updated CVD risk estimation for the contemporary Australian population. The 2023 guidelines include a discretionary step (untested in our study) allowing adjustment based on additional factors. To ensure continued reduction of CVD burden across the population, we emphasise the use of this reclassification step by clinicians and consideration of the benefits of pharmacotherapy for those at intermediate risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70280","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:30:31Z","timestamp":1788399031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distribution of Cardiovascular Disease Risk Based on the Updated 2023 Guideline\u2010Recommended Australian Cardiovascular Disease Risk Algorithm and Comparison With the 2012 Algorithm: An Observational Study"],"prefix":"10.5694","volume":"224","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6463-6719","authenticated-orcid":false,"given":"Nina","family":"Lazarevic","sequence":"first","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2474-8697","authenticated-orcid":false,"given":"Meghana","family":"Bhat","sequence":"additional","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0718-6368","authenticated-orcid":false,"given":"Grace","family":"Joshy","sequence":"additional","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle C.","family":"Butler","sequence":"additional","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Woodward","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, UNSW Sydney  Sydney New South Wales Australia"},{"name":"The George Institute for Global Health, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3825-4092","authenticated-orcid":false,"given":"Anushka","family":"Patel","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod T.","family":"Jackson","sequence":"additional","affiliation":[{"name":"University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garry","family":"Jennings","sequence":"additional","affiliation":[{"name":"Heart Foundation of Australia  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3904-9269","authenticated-orcid":false,"given":"Rosemary","family":"Wyber","sequence":"additional","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"},{"name":"The Kids Research Institute Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0855-9872","authenticated-orcid":false,"given":"Ellie","family":"Paige","sequence":"additional","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"},{"name":"QIMR Berghofer Medical Research Institute  Brisbane Queensland Australia"},{"name":"University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Banks","sequence":"additional","affiliation":[{"name":"Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Australian Institute of Health and Welfare. 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